title: Effect of initial treatment on disease outcome for patients with submandibular gland carcinoma.
abstract: OBJECTIVE
  To elucidate the effect on outcome of initial surgical enucleation with or without definitive surgical resection and radiation therapy for patients with submandibular gland carcinoma.
  
  
  METHODS
  Retrospective clinicopathological review.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Eighty-seven consecutive patients (mean follow-up, 8.7 years) with primary submandibular gland carcinoma.
  
  
  METHODS
  Review of proven cases of primary carcinomas of the submandibular gland treated at our institution during a 33-year period to determine the effect of the type of biopsy and subsequent treatment on locoregional disease control, disease-specific survival, and overall survival.
  
  
  RESULTS
  There was no statistically significant difference in locoregional disease control, disease-specific survival, or overall survival between patients undergoing enucleation of the gland vs patients undergoing enucleation of the gland followed by definitive surgical resection before any radiation therapy. There were no locoregional recurrences among 28 patients treated with enucleation and radiation therapy, compared with 3 locoregional recurrences (7%) among 42 patients treated with enucleation followed by definitive surgical resection before any radiation therapy. Twenty-nine (69%) of 42 patients undergoing a second surgical procedure had evidence of residual carcinoma in the final surgical specimen.
  
  
  CONCLUSIONS
  En bloc surgical resection followed by radiation therapy remains the standard treatment for patients with submandibular gland carcinoma. Patients without clinical and radiographic evidence of disease after enucleation may be adequately treated with subsequent radiation therapy. Definitive surgical resection remains the treatment of choice for patients with clinical or radiographic evidence of disease after enucleation of the gland.
authors.affiliation: Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 441, Houston, TX 77030, USA.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Kaszuba
authors.forename: Mark E
authors.initials: ME
authors.lastname: Zafereo
authors.forename: David I
authors.initials: DI
authors.lastname: Rosenthal
authors.forename: Adel K
authors.initials: AK
authors.lastname: El-Naggar
authors.forename: Randal S
authors.initials: RS
authors.lastname: Weber
mesh_terms: D044963:Biopsy, Fine-Needle; D002277:Carcinoma / Q000532:radiotherapy / Q000601:surgery*; D003528:Carcinoma, Adenoid Cystic / Q000532:radiotherapy / Q000601:surgery; D018277:Carcinoma, Mucoepidermoid / Q000532:radiotherapy / Q000601:surgery; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000473:pathology; D012189:Retrospective Studies; D013365:Submandibular Gland Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome