Hostname: page-component-848d4c4894-75dct Total loading time: 0 Render date: 2024-05-29T02:58:41.270Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  03 May 2018

A Cakir Cetin ,
E Dogan ,
H Ozay ,
O Kumus ,
T K Erdag ,
N Karabay ,
S Sarioglu  and
A O Ikiz
A Cakir Cetin*
Affiliation:
Department of ENT, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
E Dogan
Affiliation:
Department of ENT, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
H Ozay
Affiliation:
Department of ENT, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
O Kumus
Affiliation:
Department of ENT, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
T K Erdag
Affiliation:
Department of ENT, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
N Karabay
Affiliation:
Department of Radiology, Dokuz Eylul University, Izmir, Turkey
S Sarioglu
Affiliation:
Department of Pathology, Dokuz Eylul University, Izmir, Turkey
A O Ikiz
Affiliation:
Department of ENT, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
*
Address for correspondence: Dr Asli Cakir Cetin, Dokuz Eylul Universitesi Tip Fakultesi Hastanesi, Kulak Burun Bogaz Anabilim Dali, Balcova, Izmir 35340, Turkiye Fax: +90 232 412 32 96 E-mail: aslicakir84@hotmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

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.

Keywords

Oral NeoplasmsSubmandibular GlandOrgan PreservationNeck DissectionSquamous Cell Cancer
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 5 , May 2018 , pp. 446 - 451
Copyright
Copyright © JLO (1984) Limited 2018 

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

1Razfar, 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;31:1619–23.Google Scholar
2Shingaki, S, Takada, M, Sasai, K, Bibi, R, Kobayashi, T, Nomura, T et al. Impact of lymph node metastasis on the pattern of failure and survival in oral carcinomas. Am J Surg 2003;185:278–84.Google Scholar
3Kowalski, LP, Bagietto, R, Lara, JR, Santos, RL, Silva, JF Jr, Magrin, J. Prognostic significance of the distribution of neck node metastasis from oral carcinoma. Head Neck 2000;22:207–14.Google Scholar
4Dogan, E, Cetinayak, HO, Sarioglu, S, Erdag, TK, Ikiz, AO. Patterns of cervical lymph node metastases in oral tongue squamous cell carcinoma: implications for elective and therapeutic neck dissection. J Laryngol Otol 2014;128:268–73.Google Scholar
5Panda, NK, Patro, SK, Bakshi, J, Verma, RK, Das, A, Chatterjee, D. Metastasis to submandibular glands in oral cavity cancers: can we preserve the gland safely? Auris Nasus Larynx 2015;42:322–5.Google Scholar
6Jaguar, GC, Lima, EN, Kowalski, LP, Pellizon, AC, Carvalho, AL, Alves, FA. Impact of submandibular gland excision on salivary gland function in head and neck cancer patients. Oral Oncol 2010;46:349–54.Google Scholar
7Martin, M, Marin, A, Lopez, M, Linan, O, Alvarenga, F, Buchser, D et al. Products based on olive oil, betaine, and xylitol in the post-radiotherapy xerostomia. Rep Pract Oncol Radiother 2017;22:71–6.CrossRefGoogle ScholarPubMed
8Edge, SB, Byrd, DR, Compton, CC, Fritz, AG, Green, FL, Trotti, AE, eds. AJCC Cancer Staging Manual. New York: Springer, 2010.Google ScholarPubMed
9Malgonde, MS, Kumar, M. Practicability of submandibular gland in squamous cell carcinomas of oral cavity. Indian J Otolaryngol Head Neck Surg 2015;67:138–40.Google Scholar
10Byeon, HK, Lim, YC, Koo, BS, Choi, EC. Metastasis to the submandibular gland in oral cavity squamous cell carcinomas: pathologic analysis. Acta Otolaryngol 2009;129:96–100.Google Scholar
11Vessecchia, G, Palma, S, Giardini, R. Submandibular gland metastasis of breast carcinoma: a case report and review of the literature. Virchows Arch 1995;427:349–51.Google Scholar
12Ebrahim, AK, Loock, JW, Afrogheh, A, Hille, J. Is it oncologically safe to leave the ipsilateral submandibular gland during neck dissection for head and neck squamous cell carcinoma? J Laryngol Otol 2011;125:837–40.Google Scholar
13Kruse, A, Gratz, KW. Evaluation of metastases in the submandibular gland in head and neck malignancy. J Craniofac Surg 2009;20:2024–7.Google Scholar
14Naidu, TK, Naidoo, SK, Ramdial, PK. Oral cavity squamous cell carcinoma metastasis to the submandibular gland. J Laryngol Otol 2012;126:279–84.Google Scholar
15Spiegel, JH, Brys, AK, Bhakti, A, Singer, MI. Metastasis to the submandibular gland in head and neck carcinomas. Head Neck 2004;26:1064–8.Google Scholar
16Basaran, B, Ulusan, M, Orhan, K, Gunes, S, Suoglu, Y. Is it necessary to remove submandibular glands in squamous cell carcinomas of the oral cavity? Acta Otorhinolaryngol Ital 2013;33:88–92.Google Scholar
17DiNardo, LJ. Lymphatics of the submandibular space: an anatomic, clinical, and pathologic study with applications to floor-of-mouth carcinoma. Laryngoscope 1998;108:206–14.CrossRefGoogle ScholarPubMed
18Lim, YC, Kim, JW, Koh, YW, Kim, K, Kim, HJ, Kim, KM et al. Perivascular-submandibular lymph node metastasis in squamous cell carcinoma of the tongue and floor of mouth. Eur J Surg Oncol 2004;30:692–8.Google Scholar
19Sinha, UK, Ng, M. Surgery of the salivary glands. Otolaryngol Clin North Am 1999;32:887–906.Google Scholar
20Junquera, L, Albertos, J, Ascani, G, Baladrón, J, Vicente, J. Involvement of the submandibular region in epidermoid carcinoma of the mouth floor. Prospective study of 31 cases [in Italian]. Minerva Stomatol 1999;49:521–5.Google Scholar
21Chen, TC, Lo, WC, Ko, JY, Lou, PJ, Yang, TL, Wang, CP. Rare involvement of submandibular gland by oral squamous cell carcinoma. Head Neck 2009;31:877–81.Google Scholar
22Ashfaq, K, Ashfaq, M, Ahmed, A, Khan, M, Azhar, M. Submandibular gland involvement in early stage oral cavity carcinomas: can the gland be left behind? J Coll Physicians Surg Pak 2014;24:565–8.Google Scholar
23Fives, C, Feeley, L, Sadadcharam, M, O'Leary, G, Sheahan, P. Incidence of intraglandular lymph nodes within submandibular gland, and involvement by floor of mouth cancer. Eur Arch Otorhinolaryngol 2017;274:461–6.Google Scholar
24Kaae, JK, Stenfeldt, L, Eriksen, JG. Xerostomia after radiotherapy for oral and oropharyngeal cancer: increasing salivary flow with tasteless sugar-free chewing gum. Front Oncol 2016;6:111.Google Scholar
25Tam, M, Riaz, N, Kannarunimit, D, Pena, AP, Schupak, KD, Gelblum, DY et al. Sparing bilateral neck level IB in oropharyngeal carcinoma and xerostomia outcomes. Am J Clin Oncol 2015;38:343–7.Google Scholar
26Jha, N, Seikaly, H, Harris, J, Williams, D, Liu, R, McGaw, T et al. Prevention of radiation induced xerostomia by surgical transfer of submandibular salivary gland into the submental space. Radiother Oncol 2003;66:283–9.Google Scholar