Management of Salivary Gland Malignancy
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
...Manageme...
...Preoperative...
...roviders should perform imaging (n...
...perform computed tomography of the neck w...
...ers should perform contrast-enhanced MRI with a...
...may perform a CT/positron emission tomogra...
...should perform a tissue biopsy (either...
...rform core needle biopsy if fine needle aspiration...
...uld report risk of malignancy using...
...ogists may perform ancillary testing (imm...
...Diagnostic and The...
...s should offer open surgical excision for histolo...
...eons may request intraoperative pathologic exami...
Surgeons may perform partial superficial p...
...e of the risk of intraparotid nodal metastas...
...urgeons should perform facial nerve preservation...
...should perform resection of involved facial nerve...
...should offer an elective neck treatmen...
...operative elective neck management of...
...a cN+ neck, surgeons may perform an ipsila...
...n the setting of resectable, recurrent locoregiona...
...ng of resectable, recurrent locoregiona...
...ients undergoing revision surgery fo...
...Radiotherapy
...RT should be offered to all patients...
...operative RT should be offered to patients with...
...rative RT may be offered to patients with...
...st-operative cases, the high dose target should c...
...of perineural invasion, the associated nerve(s...
...coverage may be offered for T3–T4 pri...
...uld be initiated within 8 weeks of surgery. (IC...
...e therapy, including proton, neutron, and c...
...tive neck irradiation may be offered...
...should be offered to patients with SGM...
...Systemic The...
...f patients undergoing adjuvant rad...
...ng of patients undergoing radiotherapy for...
...with salivary gland tumors expressing a...
...Follow-up E...
...ical follow-up with history and physical ex...
...t baseline imaging with contrast CT...
...ollow-up surveillance imaging of th...
...g of the primary site and the ches...
...low-up (beyond 5 years) with yearly e...
...Recurrent/Metastatic Dise...
...presenting with metastatic diseas...
...g of adenoid cystic carcinoma and/or low grade tu...
...e considered for initiation systemic the...
...ients with adenoid cystic carcinoma wh...
...h non-adenoid cystic salivary gland cancer who...
...ic chemotherapy combinations may be offered to...
...ho are candidates for systemic therapy...
...tients with histologic tumor types with a hi...
...s who may be potential candidates for systemic th...
...of Malignancy (ROM) for Each MSRSGC Category...
...able 2. Risk of High Grade Malignancy...