Mimica X, McGill M, Hay A, et al. - In patients with salivary gland carcinoma, distant metastases (DMs) are the primary cause of treatment failure and there is no agreement on the standard treatment. Researchers here explored an institutional database of 884 patients with salivary gland cancer who underwent resection of the primary tumor between 1985 and 2015 for patients with DMs and determined their survival outcomes with the Kaplan-Meier method. Further, they sought factors associated with DM via univariate and multivariate analyses. DMs developed in 137 of the 884 patients (15%) during follow-up. The most common location was a major salivary gland of the primary tumors (n = 77 [56%]). Male gender, high-risk tumor histology, and advanced pathological T and N classifications were identified as the factors linked with shorter distant recurrence-free survival. A lower survival rate was observed in patients with bone metastases vs those with lung metastases. An inverse association was observed between the total number of DMs in a patient and survival. They identified a significantly higher 5-year rate of metastatic disease–specific survival among patients who underwent surgical resection of DMs than patients who underwent observation or nonsurgical treatment.