Submandibular gland invasion and feasibility of gland-sparing neck dissection in oral cavity carcinoma

AbstractObjective:This study investigated the incidence and routes of submandibular gland involvement in oral cavity carcinoma to determine the feasibility of submandibular gland sparing neck dissection.Methods:The records of 155 patients diagnosed with oral cavity squamous cell carcinoma, with a total of 183 neck specimens, including those involving level I, were reviewed retrospectively.Results:Submandibular gland involvement, via direct invasion from the anatomical proximity of T4a tumours, was evident in two patients. The floor of mouth location, either primarily or as an extension of the primary tumour, was the only risk factor for submandibular gland involvement in oral cavity carcinoma (p = 0.042). Tumour location, clinical and pathological tumour (T) and nodal (N) stages, and radiological suspicion of mandible invasion, were not found to be statistically relevant (p > 0.05).Conclusion:The results suggest the feasibility of preserving the submandibular gland in early stage oral cavity carcinoma unless the tumour is located in, or extends to, the floor of mouth.

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Level I Nodal Positivity as a Factor for Involvement of the Submandibular Gland in Oral Cavity Carcinoma: A Case Series Report

International Archives of Otorhinolaryngology ◽

10.1055/s-0040-1709117 ◽

2020 ◽

Author(s):

Hamdan Ahmed Pasha ◽

Rahim Dhanani ◽

Shayan Khalid Ghaloo ◽

Kulsoom Ghias ◽

Mumtaz Jamshed Khan

Keyword(s):

Oral Cavity ◽

Lymph Nodes ◽

Neck Dissection ◽

Submandibular Gland ◽

Primary Tumor ◽

Oral Carcinoma ◽

Care Hospital ◽

Direct Extension ◽

Oral Cavity Carcinoma ◽

Level I

Abstract Introduction The routine practice of neck dissection in the surgical management of oral carcinoma has evolved into a more functionally conservative approach. Over time, the rationale for removal of the submandibular gland has been questioned. Routine extirpation of the submandibular gland can aggravate the xerostomia experienced by many patients, significantly affecting their quality of life. Objective The objective of the present study was to determine the incidence of submandibular gland metastases in oral cavity carcinoma and to identify possible factors that may affect their involvement. Methods A total of 149 cases of oral carcinoma presenting at a private tertiary care hospital in Karachi, Pakistan, over the course of 1 year were reviewed retrospectively. Results Histopathological data showed that the submandibular gland was involved in 7 (4.7%) cases. Involvement of level I lymph nodes was found in all of the cases. Direct extension of primary tumor was noted in two cases when the primary tumor was in the floor of the mouth. Conclusion The results suggest that preservation of the submandibular gland during neck dissection for oral carcinoma can be practiced safely when there is no evidence of direct extension of the primary tumor toward the submandibular gland or when there is no clinical or radiological evidence of neck disease in level I. Presence of pathological lymph nodes in level I requires caution when contemplating preservation of the submandibular gland.

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Oral cavity squamous cell carcinoma metastasis to the submandibular gland

The Journal of Laryngology & Otology ◽

10.1017/s0022215111002660 ◽

2011 ◽

Vol 126 (3) ◽

pp. 279-284 ◽

Cited By ~ 9

Author(s):

T K Naidu ◽

S K Naidoo ◽

P K Ramdial

Keyword(s):

Squamous Cell Carcinoma ◽

Oral Cavity ◽

Cell Carcinoma ◽

Neck Dissection ◽

Submandibular Gland ◽

Squamous Cell ◽

Early Stage ◽

Primary Tumour ◽

Submandibular Glands ◽

Carcinoma Metastasis

AbstractIntroduction:This study aimed to evaluate the incidence of submandibular gland metastases in cases of oral cavity squamous cell carcinoma.Methods:Sixty-nine patients treated between 1 January 2004 and 30 June 2009 were retrospectively reviewed. Patients were treated with wide local excision of the primary tumour, plus simultaneous neck dissection and reconstruction if required.Results:Of 69 submandibular glands from 46 men and 23 women (mean age, 58 years), 43 (62.3 per cent) had advanced, tumour stage three or four lesions. Histopathological reappraisal of all submandibular glands demonstrated an absence of metastatic spread. Only 2/69 (2.9 per cent) submandibular glands demonstrated ipsilateral contiguous tumour involvement.Conclusion:This study demonstrated an absence of metastasis to the submandibular gland from oral cavity squamous cell carcinoma. Patients with early stage oral cavity squamous cell carcinoma and with a pre-operative node stage zero neck may be candidates for preservation of the submandibular gland during neck dissection.

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Metastasis to Submandibular Salivary Gland in Oral Carcinoma

10.37184/lntbj.2708-7808.2.5 ◽

2020 ◽

Keyword(s):

Oral Cavity ◽

Neck Dissection ◽

Submandibular Gland ◽

Squamous Cell ◽

Primary Tumor ◽

Lymph Node Involvement ◽

Submandibular Salivary Gland ◽

Floor Of Mouth ◽

Direct Invasion ◽

Node Involvement

Objective: To determine the frequency of involvement of the submandibular gland as a metastatic site in squamous cell carcinoma of oral cavity, mechanism of its involvement and factors associated with it. Method: We reviewed the medical and pathologic records of patients who underwent neck dissection (unilateral or bilateral) for oral cavity squamous cell carcinomas (SCC) from January 2009 to July 2017 at the Liaquat National Hospital in Karachi. Cases of histopathologically confirmed SCC of oral cavity and cases of primary tumor in which excision of the submandibular gland (SMG) was done along with neck dissection were included. Those cases with previous surgery for oral cancer and those with previous chemo-radiotherapy were excluded. Results: Median age at presentation was 49.50 years (IQR= 42-58 years). Males were more commonly affected (n=167, 79.5%). The most frequent involved site was buccal mucosa (n=110, 52.4%). Out of 210 neck dissections, SMG was involved by the tumor metastasis in only 8 (3.8%) of the cases. Most common method of involvement was direct invasion by the primary tumor (n=5, 62.5%). Floor of mouth (p<0.001) and level 1 lymph node involvement (p<0.001) were significantly associated with SMG involvement. Conclusion: SMG is the major source of unstimulated saliva. Saliva plays an important role in maintaining oral hygiene and health. Especially in patients of oral cavity SCC who receive post-operative radiotherapy its removal can aggravate xerostomia which can lead to severe discomfort. In this study there was no involvement of SMG in cases in which floor of mouth was not involved and in cases with clinically negative neck. So we concluded that efforts should be made to preserve SMG in these cases to reduce post-operative morbidity associated with its removal.

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Prevalence of submandibular gland involvement in neck dissection specimens of patients with oral cavity carcinoma

American Journal of Otolaryngology ◽

10.1016/j.amjoto.2021.103329 ◽

2021 ◽

pp. 103329

Author(s):

Alireza Mazarei ◽

Parnian Khamushian ◽

Mehraveh Sadeghi Ivraghi ◽

Farrokh Heidari ◽

Niloufar Saeedi ◽

...

Keyword(s):

Oral Cavity ◽

Neck Dissection ◽

Submandibular Gland ◽

Oral Cavity Carcinoma

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Mundhöhlenkarzinom: Optionen zum Erhalt der Unterkieferspeicheldrüse

Laryngo-Rhino-Otologie ◽

10.1055/a-0651-4005 ◽

2018 ◽

Vol 97 (10) ◽

pp. 666-668

Author(s):

Peter Jecker

Keyword(s):

Oral Cavity ◽

Neck Dissection ◽

Submandibular Gland ◽

Oral Cavity Carcinoma

Cakir Cetin A et al. Submandibular gland invasion and feasibility of gland-sparing neck dissection in oral cavity carcinoma. J Laryngol Otol 2018; 132: 446–451 Ärzte der medizinischen Fakultät der Universität in Izmir untersuchten Inzidenz und relevante Faktoren die mit der Beteiligung Unterkieferspeicheldrüse am Mundhöhlenkarzinom assoziiert sind. Insbesondere deswegen, um herauszufinden, ob in einem frühen Stadium des Plattenepithelkarzinoms der Mundhöhle die Möglichkeit besteht, die Unterkieferspeicheldrüse zu erhalten.

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Geographic variation in surgical practice patterns and outcomes for resected nonmetastatic gastric cancer in Ontario

Current Oncology ◽

10.3747/co.25.3953 ◽

2018 ◽

Vol 25 (5) ◽

Cited By ~ 6

Author(s):

A. L. Mahar ◽

A. El-Sedfy ◽

M. Dixon ◽

M. Siddiqui ◽

M. Elmi ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Nodes ◽

Practice Patterns ◽

Early Stage ◽

Primary Tumour ◽

Disease Stage ◽

Resection Margins ◽

Local Health ◽

Surgical Practice ◽

Tumour Location

BackgroundGastrectomy with negative resection margins and adequate lymph node dissection is the cornerstone of curative treatment for gastric cancer (gc). However, gastrectomy is a complex and invasive operation with significant morbidity and mortality. Little is known about surgical practice patterns or short- and long-term outcomes in early-stage gc in Canada.MethodsWe undertook a population-based retrospective cohort study of patients with gc diagnosed between 1 April 2005 and 31 March 2008. Chart review provided clinical and operative details such as disease stage, primary tumour location, surgical approach, operation, lymph nodes, and resection margins. Administrative data provided patient demographics, geography, and vital status. Variations in treatment and outcomes were compared for 14 local health integration networks. Descriptive statistics and log-rank tests were used to examine geographic variation.ResultsWe identified 722 patients with nonmetastatic resected gc. We documented significant provincial variation in case mix, including primary tumour location, stage at diagnosis, and tumour grade. Short-term surgical outcomes varied across the province. The percentage of patients with 15 or fewer lymph nodes removed and examined varied from 41.8% to 73.8% (p = 0.02), and the rate of positive surgical margins ranged from 15.2% to 50.0% (p = 0.002). The 30-day surgical mortality rates did not vary statistically significantly across the province (p = 0.13); however, rates ranged from 0% to 16.7%. Overall 5-year survival was 44% and ranged from 31% to 55% across the province.ConclusionsThis cohort of patients with resected stages i–iii gc is the largest analyzed in Canada, providing important historical information about treatment outcomes. Understanding the causes of regional variation will support interventions aiming to improve gc operative outcomes in the cancer system.

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Submandibular gland in early stage oral cavity cancer

The Journal of Tepecik Education and Research Hospital ◽

10.5222/terh.2015.171 ◽

2015 ◽

Author(s):

Suphi Bulgurcu ◽

İlker Burak Arslan ◽

Erhan Demirhan ◽

Melek Uncel ◽

İbrahim Çukurova

Keyword(s):

Oral Cavity ◽

Submandibular Gland ◽

Oral Cavity Cancer ◽

Early Stage

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Pathoradiological association between depth of invasion and neck node metastasis in oral cavity tumours

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20193862 ◽

2019 ◽

Vol 5 (5) ◽

pp. 1240

Author(s):

Shruti Venugopalan ◽

Sejal N. Mistry ◽

Yash D. Lavana ◽

Manish R. Mehta ◽

Paresh J. Khavdu

Keyword(s):

Oral Cavity ◽

Neck Dissection ◽

Tertiary Care ◽

Depth Of Invasion ◽

Care Hospital ◽

Neck Node ◽

Node Metastasis ◽

Oral Cavity Carcinoma ◽

Neck Node Metastasis ◽

Rule Out

Background: The aims of the study were to know whether the increase in the depth of invasion in oral cavity carcinoma assessed histopathologically and radiologically co-relates with neck node metastasis and to accurately co-relate the radiological thickness at which neck dissection is required.Methods: A retrospective study has been conducted over thirty patients with oral cavity carcinoma (buccal mucosa and tongue) in the time period of April 2018 to December 2018 who were operated in our tertiary care hospital. Results: Depth of invasion is relatable histopathologically and radiologically, is directly proportional to neck node metastasis. Pre-operative radiology is a reliable modality to rule out the need of neck node dissection.Conclusions: Depth of invasion is directly proportional to the incidence of neck node metastasis and pre-operative radiology has been reliable to rule out the need of neck dissection and reduce its morbidity.

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