Carcinomas arising in the submandibular gland: High propensity for systemic failure

✍ Scribed by Jong-Lyel Roh; Seung-Ho Choi; Sang-Wook Lee; Kyung-Ja Cho; Soon Yuhl Nam; Sang Yoon Kim

• Publisher: John Wiley and Sons
• Year: 2008
• Tongue: English
• Weight: 108 KB
• Volume: 97
• Category: Article
• ISSN: 0022-4790
• DOI: 10.1002/jso.20993

✦ Synopsis

Abstract

Background

Cancers of the submandibular gland are uncommon and only a few small series have reported patient survival and prognosis.

Methods

We examined the treatment outcomes of 62 patients with surgically treated submandibular gland carcinomas. All patients underwent surgical excision with/without neck dissection, and 41 received postoperative radiotherapy for high‐grade, invasive, positive margin, or regionally metastatic tumors. The locoregional control and survival rates were calculated by the Kaplan–Meier method and prognostic factors were calculated from uni‐ and multivariate analyses.

Results

Of the 62 submandibular gland carcinomas, 19 were adenoid cystic, 11 were mucoepidermoid, and 10 were salivary duct carcinomas, and 8 were carcinomas in pleomorphic adenoma. Actuarial 5‐year locoregional control, distant metastasis‐free survival, disease‐free and overall survival rates were 69.7%, 65.8%, 52.8%, and 56.8%, respectively. In multivariate analysis, T category and histological grading were prognostic for disease‐free survival (P < 0.01), and T category and resection margins were prognostic for locoregional control (P < 0.02). Distant metastases were found in 21 patients (33.9%) at initial staging (n = 2) or follow‐up (n = 19).

Conclusions

Despite effective locoregional treatment, approximately one‐third of patients with submandibular gland carcinomas may fail systemically, resulting in poor survival. New, more effective therapies may be required for these patients. J. Surg. Oncol. 2008;97:533–537. © 2008 Wiley‐Liss, Inc.