Home

Search

Pathway AI

Account ⋅ Sign Out

Table of contents

Salivary gland cancer

Key sources
The following summarized guidelines for the evaluation and management of salivary gland cancer are prepared by our editorial team based on guidelines from the European Reference Network on Rare Adult Solid Cancers (EURACAN/ESMO 2022), the American Society of Clinical Oncology (ASCO 2022; 2021; 2018), the American College of Radiology (ACR 2019), the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF 2017), the United Kingdom National Multidisciplinary Guidelines (UKNMG 2016), and the American Cancer Society (ACS 2016).
1
2
3
4
5
6
7
8

Guidelines

1.Classification and risk stratification

Classification: classify SGC according to the WHO Classification of Head and Neck Tumors.
A
Show 2 more
Create free account

2.Diagnostic investigations

History and physical examination: elicit an initial history and perform a physical examination in adult patients with a neck mass to identify suspicious findings representing an increased risk for malignancy.
B
Show 4 more

More topics in this section

  • Diagnostic imaging

3.Diagnostic procedures

Biopsy and pathology: as per ESMO 2022 guidelines, obtain pathological confirmation of the salivary gland tumor.
B
Show 5 more

More topics in this section

  • Ancillary testing

4.Medical management

Adjuvant chemotherapy: as per ESMO 2022 guidelines, insufficient evidence to recommend adding chemotherapy to postoperative radiotherapy of the primary tumor and neck.
I

More topics in this section

  • Definitive chemotherapy

5.Therapeutic procedures

Adjuvant radiotherapy
As per ESMO 2022 guidelines:
Offer postoperative local radiotherapy in patients with T3-T4 and intermediate/high-grade tumors and in cases with close resection margins (1-5 mm; 30×2 Gy), incomplete resection margins (33×2 Gy), or perineural growth.
B
Offer postoperative regional radiotherapy in cases with pN+ (30×2 Gy) and extranodal extension (33×2 Gy). Offer unilateral elective neck irradiation (25×2 Gy) based on the inclusion criteria for elective neck dissection.
B

More topics in this section

  • Definitive radiotherapy

  • Technical considerations for radiotherapy

6.Surgical interventions

General principles
As per ESMO 2022 guidelines:
Collect as much information as possible about the tumor before surgery, discuss scenarios with the patient, and be prepared for doing a graft during the ablative procedure.
B
Consider performing intraoperative frozen sections to evaluate margins of resection, perineural invasion, and lymph nodes, but only if the result is expected to alter management at the time of surgery.
C

More topics in this section

  • Parotid gland resection

  • Facial nerve preservation

  • Submandibular gland resection

  • Management of regional lymph nodes

7.Follow-up and surveillance

Follow-up, clinical assessment, ASCO
Obtain clinical follow-up with history and physical examination regularly with decreasing frequency as the time elapses from completion of treatment of SGC.
B
Obtain long-term follow-up (beyond 5 years) with an annual examination in all patients with SGC.
B

More topics in this section

  • Follow-up (imaging assessment)

  • Management of recurrent locoregional disease

  • Management of recurrent metastatic disease

  • Survivorship and rehabilitation (general principles)

  • Survivorship and rehabilitation (lifestyle modifications)

  • Survivorship and rehabilitation (neuromuscular complications)

  • Survivorship and rehabilitation (neurosensory complications)

  • Survivorship and rehabilitation (speech disturbance)

  • Survivorship and rehabilitation (oral and dental care)

  • Survivorship and rehabilitation (gastroesophageal complications)

  • Survivorship and rehabilitation (thyroid dysfunction)

  • Survivorship and rehabilitation (lymphedema)

  • Survivorship and rehabilitation (fatigue)

  • Survivorship and rehabilitation (sleep disorders)

  • Survivorship and rehabilitation (psychosocial distress)