Journal of Isfahan Medical School

Journal of Isfahan Medical School

Exploring the Incidence of Submandibular Gland Involvement in Head and Neck Cancer Patients Undergoing Level I Neck Dissection

Document Type : Original Article(s)

Authors
Ali Foroughi 1
Mostafi Hashemi 2
Afrooz Eshaghian 3
1 Medical Student, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Professor, Department of Otolarangology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Assistant Professor, Department of Otolarangology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
10.48305/jims.v41.i752.1219
Abstract
Background: Traditionally, the excision of submandibular glands has been a standard procedure during neck dissection. The excision of submandibular glands can decrease the patient's quality of life. However, recent investigations have suggested the absence of lymphoid tissue and a low susceptibility to metastasis in these glands, thereby negating the imperative for their removal.
Methods: In the current investigation, a retrospective analysis of medical records and imaging data about patients afflicted with head and neck cancer and subjected to Level I neck dissection was undertaken. This study aimed to assess the involvement and metastatic potential of submandibular glands and also the relationship between the grade of tumor and involvement of lymph nodes.
Findings: The findings revealed a lack of involvement of submandibular glands, thereby substantiating the rationale for preserving these glands during neck dissection. Preserving these glands can provide a better quality of life for patients. The study found no significant correlation between tumor grade and lymph node involvement.
Conclusion: Involvement of submandibular glands in head and neck cancers is rare and preserving these glands can be considered during surgery.

Highlights

Mostafa Hashemi Jazi: Google Scholar, PubMed

Afrooz Eshaghian: Google Scholar, PubMed

Keywords
Head and neck neoplasms
Neck dissection
Submandibular gland
Lymph nodes
Carcinoma squamous cell

Subjects

  1. Chow LQM. Head and neck cancer. N Engl J Med 2020; 382(1): 60-72.
  2. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2021; 71(3): 209-49.
  3. Johnson DE, Burtness B, Leemans CR, Lui VWY, Bauman JE, Grandis JR. Head and neck squamous cell carcinoma. Nat Rev Dis Primers 2020; 6(1): 92.
  4. Dhull AK, Atri R, Dhankhar R, Chauhan AK, Kaushal V. Major risk factors in head and neck cancer: a retrospective analysis of 12-year experiences. World J Oncol 2018; 9(3): 80-4.
  5. Jung K, Narwal M, Min SY, Keam B, Kang H. Squamous cell carcinoma of head and neck: what internists should know. Korean J Intern Med 2020; 35(5): 1031-44.
  6. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin 2019; 69(1): 7-34.
  7. Inchingolo F, Santacroce L, Ballini A, Topi S, Dipalma G, Haxhirexha K, et al. Oral cancer: a historical review. Int J Environ Res Public Health 2020; 17(9): 3168.
  8. Hashibe M, Sturgis EM, Ferlay J, Winn DM. Oral cavity, oropharynx, lip, and salivary glands. Schottenfeld and Fraumeni Cancer Epidemiology and Prevention. 4th Oxford, UK: Oxford University Press; 2017. p. 543-78.
  9. Chamoli A, Gosavi AS, Shirwadkar UP, Wangdale KV, Behera SK, Kurrey NK, et al. Overview of oral cavity squamous cell carcinoma: Risk factors, mechanisms, and diagnostics. Oral Oncol 2021; 121: 105451.
  10. Aupérin A. Epidemiology of head and neck
    cancers: an update. Curr Opin Oncol 2020; 32(3):
    178-86.
  11. D'souza S, Addepalli V. Preventive measures in oral cancer: An overview. Biomed Pharmacother 2018; 107: 72-80.
  12. Capote-Moreno A, Brabyn P, Muñoz-Guerra MF, Sastre-Pérez J, Escorial-Hernandez V, Rodríguez-Campo FJ, et al. Oral squamous cell carcinoma: epidemiological study and risk factor assessment based on a 39-year series. Int J Oral Maxillofac Surg 2020; 49(12): 1525-34.
  13. Lee NCJ, Kelly JR, Park HS, An Y, Judson BL, Burtness BA, et al. Patterns of failure in high-metastatic node number human papillomavirus-positive oropharyngeal carcinoma. Oral Oncol 2018; 85: 35-9.
  14. Fives C, Feeley L, Sadadcharam M, O'Leary G, Sheahan P. Incidence of intraglandular lymph nodes within the submandibular gland, and involvement by the floor of mouth cancer. Eur Arch Otorhinolaryngol 2017; 274(1): 461-6.
  15. Jakhetiya A, Kaul P, Pandey A, Patel T, Kumar Meena J, Pal Singh M, et al. Distribution and determinants of submandibular gland involvement in oral cavity squamous cell carcinoma. Oral Oncol 2021; 118: 105316.
  16. Yang S, Su JZ, Gao Y, Yu GY. Clinicopathological study of involvement of the submandibular gland in oral squamous cell carcinoma. Br J Oral Maxillofac Surg 2020; 58(2): 203-7.
  17. Grewal JS, Jamal Z, Ryan J. Anatomy, Head and Neck, Submandibular Gland. 2022 Dec 11. In: StatPearls [Online] [2022 Dec 11]. Treasure Island (FL): StatPearls Publishing.
  18. Möller I, Janta I, Backhaus M, Ohrndorf S, Bong DA, Martinoli C, et al. The 2017 EULAR standardized procedures for ultrasound imaging in rheumatology. Ann Rheum Dis 2017; 76(12): 1974-9.
  19. Yamagata K, Bukawa M, Uchida F, Fukuzawa S, Takaoka S, Ishibashi-Kanno N, et al. Involvement of submandibular gland in oral squamous cell carcinoma. J Stomatol Oral Maxillofac Surg 2024; 125(2): 101662.
  20. Cakir Cetin A, Dogan E, Ozay H, Kumus O, Erdag TK, Karabay N, et al. Submandibular gland invasion and feasibility of gland-sparing neck dissection in oral cavity carcinoma. J Laryngol Otol 2018; 132(5):
    446-51.
  21. Iocca O, Copelli C, Garzino-Demo P, Ramieri G, Rubattino S, Sedran L, et al. Submandibular gland involvement in oral cavity squamous cell carcinoma: a retrospective multicenter study. Eur Arch Otorhinolaryngol 2023; 280(9): 4205-14.
  22. Mazarei A, Khamushian P, Sadeghi Ivraghi M, Heidari F, Saeedi N, Golparvaran S, et al. Prevalence of submandibular gland involvement in neck dissection specimens of patients with oral cavity carcinoma. Am J Otolaryngol 2022; 43(2): 103329.
  23. Dhara V, Bejjihalli R, Hoda N, Kortikere S, Ghosh S, Annavarjula V. Incidence of submandibular gland involvement in oral cancer patients with positive lymph nodes: experience at a tertiary cancer centre in South India. Middle East J Cancer 2022; 13(3): 500-6.
  24. Gu B, Fang Q, Wu Y, Du W, Zhang X, Chen D. Impact of submandibular gland preservation in neck management of early-stage buccal squamous cell carcinoma on locoregional control and disease-specific survival. BMC Cancer 2020; 20(1): 1034.
  25. Kumar B. The composition, function, and role of saliva in maintaining oral health: A review. 1International Journal of Contemporary Dental and Medical Reviews 2017.
  26. O’Keefe KJ, DeSantis KA, Altrieth AL, Nelson DA, Taroc EZM, Stabell AR, et al. Regional Differences Following Partial Salivary Gland Resection. J Dent Res 2020; 99(1): 79-88.

Dundar Y, Mandle Q, Raza SN, Lin H-S, Cramer J, Hotaling JM. Submandibular Gland Invasion by Oral Cavity Cancers: A Systematic Review. Otolaryngol Head Neck Surg 2019; 161(2): 227-34

Journal of Isfahan Medical School
Volume 41, Issue 752
4th Week, March
March and April 2024
Pages 1219-1225