A multicenter validation of the revised version of the Milan system for reporting salivary gland cytology (MSRSGC)

F Mazzola; M Tomasoni; D Mocellin; M Dalè; A Iandelli; A Carobbio; F Marchi; M Filauro; G Petruzzi; B Massa; M Facchetti; S Battocchio; F Marandino; D Lombardi; B Pichi; R Pellini; P Nicolai; G Peretti

doi:10.1016/j.oraloncology.2020.104867

A multicenter validation of the revised version of the Milan system for reporting salivary gland cytology (MSRSGC)

Oral Oncol. 2020 Jun 25:109:104867. doi: 10.1016/j.oraloncology.2020.104867. Online ahead of print.

Authors

F Mazzola¹, M Tomasoni², D Mocellin³, M Dalè³, A Iandelli³, A Carobbio³, F Marchi³, M Filauro⁴, G Petruzzi⁵, B Massa⁶, M Facchetti⁷, S Battocchio⁷, F Marandino⁸, D Lombardi², B Pichi⁵, R Pellini⁵, P Nicolai⁹, G Peretti³

Affiliations

¹ Unit of Otorhinolaryngology and Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Viale Benedetto XV, 6, 16132, Genoa, Italy; Department of Otolaryngology - Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53, 00144, Rome, Italy. Electronic address: mazzola.fra@gmail.com.
² Unit of Otorhinolaryngology, Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Piazzale Spedali Civili, 1 - 25123, Brescia, Italy.
³ Unit of Otorhinolaryngology and Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Viale Benedetto XV, 6, 16132, Genoa, Italy.
⁴ Unit of Otorhinolaryngology and Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Viale Benedetto XV, 6, 16132, Genoa, Italy; Department of Experimental Medicine (DIMES), University of Genoa, Via Leon Battista Alberti, 2, 16132, Genoa, Italy.
⁵ Department of Otolaryngology - Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53, 00144, Rome, Italy.
⁶ Cyto-Histopathological Unit and Pathology Unit, Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy.
⁷ Unit of Pathology, Department of Molecular and Translational Medicine, University of Brescia, Piazzale Spedali Civili, 1 - 25123, Brescia, Italy.
⁸ Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
⁹ Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padua, Via Giustiniani, 2 - 35128 Padua, Italy.

PMID: 32593953
DOI: 10.1016/j.oraloncology.2020.104867

Abstract

Introduction: Fine-needle aspiration cytology (FNAC) is a basic step in the diagnosis of salivary gland tumors that have a wide variety of histological types. The recent Milan system for reporting salivary gland cytopathology (MSRSGC) can correlate the risk of malignancy with precise cytological features. A revised version was recently proposed to improve the surgical relevance and facilitate uniform management.

Material and methods: A multicenter study retrospectively used the original and revised MSRSGC criteria to classify a series of patients who received surgery after FNAC.

Results: We enrolled 503 patients from three tertiary centers. The risk of malignancy for the MSRSGC resulted 19.5% in cat. I, 14.3% in cat. II, 17.6% in cat. III, 3.6% in cat. IVa, 24.6% in cat. IVb, 66.7% in cat. V, and 96.8% in cat. VI. The results from the revised MSRSGC were consistent with the original values.

Conclusion: The MSRSGC is a promising classification system. In our opinion, the revised version of the MSRSGC supplements FNAC with some crucial clinical information and can better identify the appropriate treatment in each category.

Keywords: Fine-needle aspiration cytology; Head and Neck cancer; MSRSGC; Milan classification; Risk of malignancy; Salivary gland cytology; Salivary gland tumors.