Management of malignant submandibular gland tumors: A 30-year experience from a single center

Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 Sep;134(3):302-309. doi: 10.1016/j.oooo.2022.01.023. Epub 2022 Feb 4.


Objective: Owing to histologic heterogeneity, biological behavior, and rarity, recommendations for the treatment of malignant submandibular gland tumors (MSGT) are inconsistent. The aim of this study was to present a single-center experience in the treatment of MSGT with an emphasis on surgical treatment, including indication on elective neck dissection (END).

Study design: Twenty-four MSGT were primary surgically treated (gland excision with neck dissection). Their records were retrospectively collected and analyzed.

Results: The most frequent histology was adenoid cystic carcinoma (41.6%), followed by mucoepidermoid carcinoma (25%) and carcinoma ex pleomorphic adenoma (16.7%). There were 18 elective and 6 therapeutic neck dissections. Histopathologic examination confirmed 29% (7/24) of positive neck dissection specimens. The Kaplan-Meier analysis presented rates of disease-specific survival, disease-free survival, and overall survival (OS) of 81%, 78%, and 52% at 5 years, respectively. Patients undergoing postoperative radiotherapy had significantly higher OS rates compared with patients treated with surgery alone (P = .0209).

Conclusion: Results of this study suggest that END has questionable benefit in early stage MSGT. Elective selective neck dissection levels I-III is recommended in high-grade and advanced stage MSGT without evidence of multilevel lymphadenopathy.

MeSH terms

  • Adenoma, Pleomorphic* / pathology
  • Carcinoma, Adenoid Cystic* / surgery
  • Humans
  • Retrospective Studies
  • Salivary Gland Neoplasms* / pathology
  • Salivary Gland Neoplasms* / surgery
  • Submandibular Gland Neoplasms* / diagnosis
  • Submandibular Gland Neoplasms* / surgery