The possibility of predicting the risk of recurrence in malignant salivary gland tumors

Objective: To study prognostic markers of recurrence in malignant salivary gland tumors and develop algorithms for personalized risk prediction. Materials and Methods: A systematic analysis of 68 scientific publications (2000-2023), including 42 studies from the last 5 years, was conducted using databases such as Scopus, Web of Science, MedLine, PubMed, and eLIBRARY.ru. The search was performed using key terms related to predicting recurrences of salivary gland tumors. The GRADE scale was applied to assess source reliability, identifying 20 Level I studies. The research methods included synthesis of clinical data, analysis of molecular-genetic markers, and evaluation of the prognostic value of various biomarkers. Results: Accurate prediction of recurrence risk requires integration of clinical, histomorphological, molecular-genetic, and immunological parameters. Translocations MYB-NFIB and CRTC1-MAML2 were identified as key prognostic markers for adenoid cystic and mucoepidermoid carcinomas, respectively. High density of CD8+ T-lymphocytes (>500 cells/mm²) is associated with a three-fold reduction in recurrence risk, while PD-L1 expression >10% increases the likelihood of recurrence by 2.8 times. The developed SGCRS scale allows stratification of patients into risk groups with 89% accuracy. Next-generation sequencing revealed a «recurrence signature set» of 12 genes that predicts recurrence with 92% sensitivity and 85% specificity. Analysis of circulating tumor DNA (ctDNA) enables detection of molecular signs of recurrence 8–12 months before clinical manifestation. Conclusion: Integration of multifactorial data into a unified prognostic system, including genomic, proteomic, and immunological markers, significantly improves the accuracy of predicting recurrence in malignant salivary gland tumors. This creates the basis for personalized selection of adjuvant therapy, which has the potential to dramatically improve long-term treatment outcomes and enhance patients' quality of life.