Submandibular Gland Involvement in Head and Neck Cancers: A Single-center Retrospective Study of 175 Cases: Submandibular Gland Involvement in Head and Neck Cancers

Authors

Muhittin Akalın Department of Otolaryngology and Head & Neck Surgery, University of Health Sciences Türkiye, Ankara Bilkent City Hospital, Ankara, Türkiye
Mehmet Ekrem Zorlu Department of Otolaryngology and Head & Neck Surgery, Gazi University, Faculty of Medicine, Ankara, Türkiye
Emirhan Akyol Clinic of Otorhinolaryngology and Head & Neck Surgery, Adıyaman Training and Research Hospital, Adıyaman, Türkiye
Betül Öğüt Department of Pathology, Gazi University, Faculty of Medicine, Ankara, Türkiye
Utku Aydil Department of Otolaryngology and Head & Neck Surgery, Gazi University, Faculty of Medicine, Ankara, Türkiye
Metin Yılmaz Department of Otolaryngology and Head & Neck Surgery, Gazi University, Faculty of Medicine, Ankara, Türkiye
Mehmet Düzlü Department of Otolaryngology and Head & Neck Surgery, Gazi University, Faculty of Medicine, Ankara, Türkiye

Keywords:

Head and neck neoplasms, submandibular gland, neck dissection, mouth neoplasms, squamous cell carcinoma of head and neck, lymphatic metastasis

Abstract

Objective: The submandibular gland is routinely removed during level Ib neck dissection for head and neck cancer. This study evaluated the feasibility of gland preservation in appropriate patients considering oncological risks.
Methods: This retrospective study evaluated 175 patients with head and neck cancer who underwent neck dissection including Level Ib between 2015 and 2024. Level Ib nodal status was assessed in all patients, whereas submandibular gland involvement was evaluated in patients with at least one excised gland (n = 165). Overall survival (OS) and recurrence-free survival (RFS) were compared between gland-sparing and non-gland-sparing surgery in the oral cavity squamous cell carcinoma (SCC) cohort (n = 125) using the Kaplan-Meier method and log-rank test.
Results: The predominant histopathological type was SCC (89.1%), and the oral cavity was the most common tumor site (72.0%). Submandibular gland involvement was observed in 1 of 165 patients (0.6%). In the oral cavity SCC cohort, no statistically significant differences were found in OS (p = 0.288) or RFS (p = 0.936) between gland-sparing surgery (n = 12) and non-gland-sparing surgery (n = 113).
Conclusion: Submandibular gland involvement is rare, and gland-sparing surgery may be viable in carefully selected oral cavity SCC patients. Larger studies are required to clarify oncological reliability and functional benefits and support patient selection criteria for preservation.

Submandibular Gland Involvement in Head and Neck Cancers: A Single-center Retrospective Study of 175 Cases