Carcinomas arising in the submandibular gland: high propensity for systemic failure.
BACKGROUND
Cancers of the submandibular gland are uncommon and only a few small series have reported patient survival and prognosis.


METHODS
We examined the treatment outcomes of 62 patients with surgically treated submandibular gland carcinomas. All patients underwent surgical excision with/without neck dissection, and 41 received postoperative radiotherapy for high-grade, invasive, positive margin, or regionally metastatic tumors. The locoregional control and survival rates were calculated by the Kaplan-Meier method and prognostic factors were calculated from uni- and multivariate analyses.


RESULTS
Of the 62 submandibular gland carcinomas, 19 were adenoid cystic, 11 were mucoepidermoid, and 10 were salivary duct carcinomas, and 8 were carcinomas in pleomorphic adenoma. Actuarial 5-year locoregional control, distant metastasis-free survival, disease-free and overall survival rates were 69.7%, 65.8%, 52.8%, and 56.8%, respectively. In multivariate analysis, T category and histological grading were prognostic for disease-free survival (P < 0.01), and T category and resection margins were prognostic for locoregional control (P < 0.02). Distant metastases were found in 21 patients (33.9%) at initial staging (n = 2) or follow-up (n = 19).


CONCLUSIONS
Despite effective locoregional treatment, approximately one-third of patients with submandibular gland carcinomas may fail systemically, resulting in poor survival. New, more effective therapies may be required for these patients.
Roh
Jong-Lyel
JL
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Choi
Seung-Ho
SH
Lee
Sang-Wook
SW
Cho
Kyung-Ja
KJ
Nam
Soon Yuhl
SY
Kim
Sang Yoon
SY
D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D003528:Carcinoma, Adenoid Cystic / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy; D018277:Carcinoma, Mucoepidermoid / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D013365:Submandibular Gland Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D015996:Survival Rate; D017211:Treatment Failure; D016896:Treatment Outcome