A gland of diverse pathology and unpredictable behaviour: our experience of primary submandibular gland malignancies

Int J Oral Maxillofac Surg. 2018 Oct;47(10):1243-1249. doi: 10.1016/j.ijom.2018.05.012. Epub 2018 May 24.

Abstract

Submandibular gland tumours are relatively uncommon tumours and demonstrate diverse histological types and a variable prognosis. The aim of this study was to analyze our experience with submandibular malignancies over a period of 6 years (January 2009 to December 2015). Patient data from the 6-year period were reviewed retrospectively and 51 patients with submandibular malignancies were identified. Demographic data, clinicopathological details, treatment received, complications, and follow-up were recorded. The mean age of the 51 patients at presentation was 49.1 years. They were followed up for a mean 20.3 months. Nine of 47 patients (19.1%) developed distant metastasis during follow-up, while only three (6.4%) developed local recurrence. Disease-free survival at 2 years was 69.7% and overall survival at the end of 2 years was 77.8%. Actuarial 5-year survival was 57.8% when all subtypes were considered. The overall mean time to recurrence was 10 months (6-24 months). Nodal positivity was the only prognostic factor that was significant on multivariate analysis, while age, sex, perineural invasion, and grade were not. With advances in surgical and radiotherapy techniques, loco-regional control rates have improved greatly; however, effective adjuvant treatment to prevent systemic relapse is still lacking.

Keywords: adenoid cystic carcinoma; lymph node metastasis; mucoepidermoid carcinoma; salivary gland malignancies; submandibular gland malignancies.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Lymphatic Metastasis / pathology
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Metastasis / pathology
  • Neoplasm Metastasis / therapy
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / therapy
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Submandibular Gland Neoplasms / complications
  • Submandibular Gland Neoplasms / pathology*
  • Submandibular Gland Neoplasms / therapy
  • Survival Rate