Postoperative Management of Salivary Gland Tumors

Opinion statement Salivary gland tumors represent a heterogeneous group of neoplasms characterized by varied histologies and disease outcomes. Initial treatment for the primary and gross nodal disease is usually surgery. Management of the clinically node-negative neck depends upon the risk of lymph nodal involvement. This is usually determined by the AJCC T stage and histology. Both surgery and radiation may be utilized to address the lymph nodes at risk. This is especially important for minor salivary gland tumors. Radiation plays an important role in the adjuvant management of salivary gland tumors by reducing the risk of locoregional recurrence. Certain histologies like adenoid cystic carcinoma have a predilection for neurotropic spread to the skull base. Radiation is particularly important in controlling disease at the skull base. The role of concurrent chemotherapy in the adjuvant treatment of salivary gland tumors is not established and remains an area of active research. Certain histologies like salivary duct carcinoma exhibit readily identifiable molecular targets amenable to targeted therapy. Finally, advanced testing of these tumors using next-generation sequencing can also potentially identify molecular targets amenable to therapy. While useful in the management of metastatic disease, the role of these therapies in the adjuvant setting remains unknown.

Automated summary

Salivary gland tumors are a diverse group of neoplasms with varying histologies and outcomes. Treatment usually involves surgery for primary and gross nodal disease, with the management of clinically node-negative neck depending on lymph nodal risk. Both surgery and radiation can be used to address at-risk lymph nodes, especially for minor salivary gland tumors. Radiation plays a crucial role in reducing locoregional recurrence risk and controlling disease at the skull base.