Prognostic factors and treatment considerations of submandibular gland carcinomas: A population-based study.

Shengwen Liu Wanlin Xu Limin Liu Yun Zhu Yifan Wu Hao Lu Wenjun Yang Chenping Zhang

Oral Dis

Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Department of Oral and Maxillofacial-Head and Neck Oncology, National Clinical Research Center for Oral Disease, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Published: November 2023

The study investigates the treatment options for submandibular gland carcinoma (SGC), particularly focusing on patients with no clinical neck involvement (cN0).
After analyzing data from 215 patients, the findings reveal that the 5-year disease-free survival and overall survival rates are 71.5% and 77.8%, with several factors like histological grade and classification affecting these rates.
The research concludes that neck dissection is not beneficial for cN0 patients, and highlights the importance of postoperative radiotherapy for those with positive neck involvement (pN+).

Objectives: The therapeutic regimen of submandibular gland carcinoma (SGC) has not reached consensus, especially for the neck treatment of patients with cN0.

Materials And Methods: Patients with SGC were identified from the medical database of Shanghai Ninth People's Hospital. Kaplan-Meier analysis, univariate and multivariate Cox regression were employed to evaluate the survival and independent prognostic factors.

Results: Two hundred and fifteen patients with SGC were retrospectively reviewed. The 5-year disease-free survival (DFS) and overall survival (OS) rates were 71.5% and 77.8%, respectively. Multivariate analysis revealed that histological grade, cT classification, cN classification, and perineural invasion (PNI) were independent prognostic factors for DFS, while histological grade, cT classification, cN classification, and age were those for OS. The neck dissection showed no significant survival benefit for patients with cN0. Lung was the most common site of distant metastasis (16.7%).

Conclusions: Histological grade, cT classification, cN classification, age, and PNI were independent prognostic factors of patient with SGC, which should be the main considerations for making therapeutic regimens. Our study also verifies the neck dissection of patient with cN0 is unnecessary, and postoperative radiotherapy (PORT) is vital for patients with pN+.

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http://dx.doi.org/10.1111/odi.14313	DOI Listing

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