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

...nagemen...

...perative Evaluation...

...ders should perform imaging (neck ultrasound, C...

...s should perform computed tomography of the...

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

...may perform a CT/positron emission tomog...

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

...ay perform core needle biopsy if fine needle...

...athologists should report risk of maligna...

...ts may perform ancillary testing (immunohistoch...


...agnostic and Therapeutic Surgical Procedu...

...offer open surgical excision for hi...

...request intraoperative pathologic examination to s...

...perform partial superficial parotidectomy fo...

...he risk of intraparotid nodal metas...

...ould perform facial nerve preservation in pat...

...rgeons should perform resection of involved...

...geons should offer an elective neck treatment ove...

...perative elective neck management of saliv...

...eck, surgeons may perform an ipsilateral...

...f resectable, recurrent locoregional...

...the setting of resectable, recurrent locor...

...ndergoing revision surgery for recurrent sal...


Radiotherapy

...erative RT should be offered to all patients with...

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

...st-operative RT may be offered to p...

...operative cases, the high dose target should...

...n the case of perineural invasion, th...

...ective nodal coverage may be offere...

...should be initiated within 8 weeks of su...

...py, including proton, neutron, and...

...ive neck irradiation may be offered in pati...

...erapy should be offered to patient...


...emic Therapy...

...etting of patients undergoing adjuvant r...

...of patients undergoing radiotherapy for non-o...

...nts with salivary gland tumors expre...


...low-up Evaluati...

...up with history and physical exam shoul...

...t baseline imaging with contrast CT...

...illance imaging of the primary site (contrast C...

...-up imaging of the primary site and the chest fr...

...g-term follow-up (beyond 5 years) with...


...rrent/Metastatic Diseas...

...ing with metastatic disease may be evaluated f...

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

...ts may be considered for initiation syste...

...ith adenoid cystic carcinoma who are ca...

...ts with non-adenoid cystic salivary gland c...

...hemotherapy combinations may be offered to pat...

...r patients who are candidates for systemic therap...

...ients with histologic tumor types with a high prev...

...may be potential candidates for systemic therapy...


...of Malignancy (ROM) for Each MSRSGC CategoryHa...


...f High Grade Malignancy (ROHM) for Each MSRSGC...