A nomogram to estimate the risk of developing distant metastases in parotid cancer
Luca Giovanni Locatello MD  Angelo Cannavicci MD  Chiara Bruno MD  Giandomenico Maggiore MD Vincenzo Napoleone MSc  Oreste Gallo MD
First published: 04 July 2019 https://doi.org/10.1002/hed.25843
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Abstract
Background
Parotid cancer (PC) is a heterogeneous group of malignant tumors whose management mainly focuses on locoregional control. However, distant metastases (DM) can represent the most common cause of treatment failure. We have defined the predictors and developed a model that can predict a single patient's risk to develop DM.

Methods
We have analyzed our institutional database of 259 patients with PC and use it to develop a nomogram. C‐index and calibration curves were used to assess performance of our model.

Results
DM appeared in 18.9% of patients. Age, cT, pN, perineural invasion, and adenoid cystic carcinoma were significantly associated with distant failure.

Conclusions
We here present the first model to identify patients with PC at high risk of DM. Such tool can be of great value in managing these rare cancers in terms of a more precise prognosis and follow‐up while waiting for better systemic therapies to come in the future.