Management of Salivary Gland Malignancy

Publication Date: April 1, 2021

Key Points

Key Points

  • Because salivary gland malignancies (SGMs) account for less than 5% of all head and neck cancers, there are limited clinical trial data to help guide therapy.
  • Optimal treatment requires appropriate pathologic technique to differentiate among the wide spectrum of histologies and the variety of biological behaviors seen in SGMs.

Management

...agement...

...rative Evaluatio...

...ers should perform imaging (neck ultrasou...

...roviders should perform computed tomograp...

...ders should perform contrast-enhanced...

...rs may perform a CT/positron emission tomogr...

...perform a tissue biopsy (either fine needle...

...rs may perform core needle biopsy i...

...ists should report risk of malignancy...

...ologists may perform ancillary testing (immunohis...


...c and Therapeutic Surgical Procedure...

...ould offer open surgical excision f...

...ay request intraoperative pathologic examination...

...erform partial superficial parotidectomy for appr...

...of the risk of intraparotid nodal metastases in h...

...d perform facial nerve preservation in patie...

Surgeons should perform resection of...

...should offer an elective neck treatment over...

...elective neck management of salivar...

...+ neck, surgeons may perform an ip...

In the setting of resectable, recurrent l...

...of resectable, recurrent locoregional diseas...

...oing revision surgery for recurrent salivary glan...


...adiother...

...ive RT should be offered to all patients...

...-operative RT should be offered to patients wi...

...perative RT may be offered to patients...

...ve cases, the high dose target should co...

...e of perineural invasion, the associa...

...l coverage may be offered for T3–T4...

...be initiated within 8 weeks of surge...

...e therapy, including proton, neutron, and...

...ctive neck irradiation may be offered in patients...

...rapy should be offered to patients with SGM who a...


Systemic Th...

...f patients undergoing adjuvant radiothera...

...e setting of patients undergoing radiot...

...salivary gland tumors expressing androgen...


...ollow-up Evalua...

...follow-up with history and physical exam should...

...t-treatment baseline imaging with contr...

...rveillance imaging of the primary site (co...

...ow-up imaging of the primary site and...

...ong-term follow-up (beyond 5 years)...


Recurrent/Metastatic D...

Patients presenting with metastatic dis...

...ng of adenoid cystic carcinoma and/or low...

...e considered for initiation systemic ther...

...ients with adenoid cystic carcinoma who...

...nts with non-adenoid cystic salivary gland canc...

...otoxic chemotherapy combinations may...

...o are candidates for systemic thera...

...s with histologic tumor types with a high prevale...

...y be potential candidates for systemic therap...


...le 1. Risk of Malignancy (ROM) for Ea...


...of High Grade Malignancy (ROHM) f...