Evidence map›Paper›PMID 41416670›Full record

ArticleCancer cytopathology2026

Fine-needle aspiration cytology reduces the frequency of surgeries for malignant salivary gland tumors.

Marcel Mayer, Sofia Kourou, Marwan Alfarra, Charlotte Laatz, Kevin Hansen, Julia Esser, Hans Nikolaus Caspar Eckel, Kathrin Möllenhoff, Lena Hieggelke, Marianne Engels and 7 more

Erratum issuedAbstract read
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In one paragraph

Article in Cancer cytopathology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors.

Marcel MayerDepartment of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne, Germany.ORCID 0000-0001-9963-1109
Sofia KourouDepartment of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne, Germany.ORCID 0009-0000-2277-4160
Marwan AlfarraDepartment of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne, Germany.
Charlotte LaatzDepartment of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne, Germany.
Kevin HansenDepartment of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne, Germany.
Julia EsserDepartment of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne, Germany.
Hans Nikolaus Caspar EckelDepartment of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne, Germany.
Kathrin MöllenhoffInstitute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany.
Lena HieggelkeInstitute of Pathology, University of Cologne, Medical Faculty, Cologne, Germany.
Marianne EngelsInstitute of Pathology, University of Cologne, Medical Faculty, Cologne, Germany.
Christoph AroltInstitute of Pathology, University of Cologne, Medical Faculty, Cologne, Germany.
Alexander QuaasInstitute of Pathology, University of Cologne, Medical Faculty, Cologne, Germany.
Philipp WolberDepartment of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne, Germany.
Louis JansenDepartment of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne, Germany.ORCID 0000-0003-0332-1099
Lisa NachtsheimDepartment of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne, Germany.
Jens Peter KlussmannDepartment of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne, Germany.
Sami ShabliDepartment of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSalivary gland tumors are rare and heterogeneous head and neck neoplasms. Preoperative distinction between benign and malignant lesions is challenging because imaging is often insufficient. Fine-needle aspiration cytology (FNAC) combined with the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) provides standardized risk stratification and diagnostic guidance; however, its influence on surgical frequency remains insufficiently characterized.

methodsThis retrospective single-center study included patients with histologically confirmed malignant tumors within the major salivary glands with preoperative FNAC and surgery. The association between MSRSGC category and number of surgeries was evaluated using χ

resultsOverall, 157 patients were included. Those with high-to-intermediate-risk MSRSGC categories (two surgeries: 22.3% vs. one surgery: 77.7%) required significantly fewer surgeries than those with low-risk/nondiagnostic FNAC (two surgeries: 54.2%/53.3% vs. one surgery: 45.8%/46.7%, p < .001). A high-to-intermediate risk compared to a nondiagnostic FNAC results was an independent predictor for fewer surgeries in multivariate analysis (incidence rate ratio, 0.875; 95% confidence interval, 0.773-0.990; p = .034). True-positive results were most frequent in squamous cell carcinoma, whereas acinic cell and mucoepidermoid carcinomas were often misclassified.

conclusionsThe use of the MSRSGC enables reliable preoperative risk stratification of malignant salivary gland tumors. High-to-intermediate-risk categories (Milan III/IVb/V/VI) were associated with a lower likelihood of multiple surgeries. True-positive FNAC results were most frequent in squamous cell carcinoma and metastatic melanoma, whereas acinic cell, mucoepidermoid, and salivary duct carcinomas were prone to misclassification. Structured FNAC reporting improves diagnostic accuracy and informs personalized surgical planning, reducing interventions and optimizing management.

Indexed as

Salivary Gland NeoplasmsAdultAgedAged, 80 and overBiopsy, Fine-NeedleCytodiagnosisFemaleHumansMaleMiddle AgedRetrospective StudiesSalivary GlandsYoung Adultcytologyfine‐needle aspiration cytologyhead and neck carcinomaMilan System for reporting Salivary Gland Cytopathologysalivary gland carcinomasonography

Identifiers

PMID41416670
PMCPMC12716000

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.