Skip to main content Accessibility help
×
Home
Hostname: page-component-684899dbb8-gbqfq Total loading time: 0.224 Render date: 2022-05-22T13:53:05.484Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true }

Is it oncologically safe to leave the ipsilateral submandibular gland during neck dissection for head and neck squamous cell carcinoma?

Published online by Cambridge University Press:  02 June 2011

A K Ebrahim*
Affiliation:
Department of Otorhinolaryngology, Faculty of Health Science, University of Stellenbosch/Tygerberg Academic Hospital, Cape Town, South Africa
J W Loock
Affiliation:
Department of Otorhinolaryngology, Faculty of Health Science, University of Stellenbosch/Tygerberg Academic Hospital, Cape Town, South Africa
A Afrogheh
Affiliation:
Department of Anatomical Pathology, Faculty of Health Science, University of Stellenbosch/Tygerberg Academic Hospital, Cape Town, South Africa
J Hille
Affiliation:
Department of Anatomical Pathology, Faculty of Health Science, University of Stellenbosch/Tygerberg Academic Hospital, Cape Town, South Africa
*
Address for correspondence: Dr Abdul Kader Ebrahim, Registrar, Department of Otorhinolaryngology, Faculty of Health Science, University of Stellenbosch/Tygerberg Academic Hospital, Cape Town, Private Bag X3, Tygerberg 7505, South Africa E-mail: akebrahim@gmail.com

Abstract

Aim:

To investigate the incidence of metastasis to the submandibular gland in patients with head and neck squamous cell carcinoma.

Methods:

We retrospectively evaluated histological reports of neck dissections for upper respiratory tract carcinoma (performed 2002–2009), recording: primary tumour site, tumour–node–metastasis stage, level Ib involvement, previous radiotherapy, perineural invasion, lymphovascular invasion, extracapsular spread, and the presence of malignant disease in the submandibular gland.

Results:

We evaluated 107 cases. The most common primary site was the oral cavity (49 per cent) followed by the supraglottis (21 per cent), glottis (14 per cent), oropharynx (9 per cent) and hypopharynx (6 per cent). Forty-eight per cent of patients had advanced local disease, with 21 per cent at tumour stage 3 and 27 per cent at tumour stage 4. Fifty-six per cent had cervical lymph node metastasis, and 8 per cent received pre-operative radiotherapy. Forty-eight per cent had perineural invasion, 46 per cent lymphovascular spread, 27 per cent extracapsular spread and 8 per cent level Ib metastasis. Only one patient had submandibular gland involvement, due to direct spread (a case with prior radiotherapy and macroscopic submandibular gland involvement evident peri-operatively).

Conclusion:

Submandibular gland metastasis from head and neck primary squamous cell carcinoma is extremely rare. Preservation of the ipsilateral submandibular gland during neck dissection is oncologically safe, except in patients with prior surgery or radiotherapy, or a primary tumour in close relation to the gland.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Byeon, HK, Lim, YC, Koo, BS, Choi, EC. Metastasis to the submandibular gland in oral cavity squamous cell carcinomas: Pathologic analysis. Acta Otolarygol 2009;129:96100CrossRefGoogle ScholarPubMed
2Bocca, E, Pignataro, A. A conservation technique in radical neck dissection. Ann Otol Rhinol Laryngol 1967;77:975–87CrossRefGoogle Scholar
3Mercante, G, Bacciu, A, Oretti, G, Ferri, T. Involvement of level I neck lymph nodes and submandibular gland in laryngeal and/or hypopharyngeal squamous cell carcinoma. J Otolaryngol 2006;35:108–11CrossRefGoogle ScholarPubMed
4DiNardo, LJ. Lymphatics of the submandibular space: an anatomic, clinical and pathologic study with applications to floor of mouth carcinoma. Laryngoscope 1998;108:206–14CrossRefGoogle ScholarPubMed
5Vaidya Atul, M, Vaidya Abhay, M, Petruzellie, GJ, McClatchey, KD. Isolated submandibular gland metastasis from oral cavity squamous cell carcinoma. Am J Otolaryngol 1999;20:172–5CrossRefGoogle Scholar
6Jacob, RF, Weber, RS, King, GE. Whole salivary flow rates following submandibular gland resection. Head Neck 1996;18:242–73.0.CO;2-#>CrossRefGoogle ScholarPubMed
7Jha, N, Seikaly, H, Harris, J, Williams, D, Lui, R, McGaw, T et al. Prevention of radiation induced xerostomia by surgical transfer of submandibular salivary gland into the submental space. Radiother Oncol 2003;66:283–9CrossRefGoogle ScholarPubMed
8Spiegel, JH, Brys, AK, Bhakti, A, Singer, MI. Metastasis to the submandibular gland in head and neck carcinomas. Head Neck 2004;12:1064–8CrossRefGoogle Scholar
9Razfar, A, Walvekar, RR, Melkane, A, Johnson, JT, Myers, EN. Incidence and patterns of regional metastasis in early oral squamous cell cancers: feasibility of submandibular gland preservation. Head Neck 2009;10:1619–23CrossRefGoogle Scholar
10Chen, TC, Lo, WC, Ko, JY, Lou, PJ, Yang, TL, Wang, CP. Rare involvement of submandibular gland by oral squamous cell carcinoma. Head Neck 2009;10:877–81CrossRefGoogle Scholar
11Vessecchia, G, Di Palma, S, Giardini, R. Submandibular gland metastases of breast carcinoma; a case report and a review of literature. Virchows Arch 1995;427:349351CrossRefGoogle Scholar
12Saarilahti, K, Kouri, M, Collan, J, Kangasmaki, A, Atua, T, Joensuu, H et al. Sparing of the submandibular glands by intensity modulated radiotherapy in the treatment of head neck cancer. Radiother Oncol 2006;78:270–5CrossRefGoogle Scholar
25
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Is it oncologically safe to leave the ipsilateral submandibular gland during neck dissection for head and neck squamous cell carcinoma?
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Is it oncologically safe to leave the ipsilateral submandibular gland during neck dissection for head and neck squamous cell carcinoma?
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Is it oncologically safe to leave the ipsilateral submandibular gland during neck dissection for head and neck squamous cell carcinoma?
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *