Malignant salivary gland tumors: Treatment of recurrent and metastatic disease
- Scott A Laurie, MD, FRCPC
Scott A Laurie, MD, FRCPC
- The Ottawa Hospital Cancer Centre
- University of Ottawa
- Bradley Schiff, MD
Bradley Schiff, MD
- Associate Professor
- Albert Einstein College of Medicine
- Section Editors
- Bruce E Brockstein, MD
Bruce E Brockstein, MD
- Section Editor — Cancer of the Head and Neck
- Clinical Professor of Medicine
- University of Chicago Pritzker School of Medicine
- Marshall R Posner, MD
Marshall R Posner, MD
- Section Editor — Cancer of the Head and Neck
- Professor of Gene and Cell Medicine
- The Tisch Cancer Institute
- Icahn School of Medicine at Mount Sinai
- David M Brizel, MD
David M Brizel, MD
- Section Editor — Radiation Therapy
- Leonard R Prosnitz Professor of Radiation Oncology
- Professor of Otolaryngology Head & Neck Surgery
- Duke University Cancer Institute
- Marvin P Fried, MD, FACS
Marvin P Fried, MD, FACS
- Section Editor — Head and Neck Surgery
- Professor and University Chairman, Department of Otorhinolaryngology - Head and Neck Surgery
- Montefiore Medical Center, Albert Einstein College of Medicine
Salivary glands produce and secrete saliva from a glandular structure, the secretory acinus, the ducts, and the myoepithelial and basal cells. Salivary gland tumors can be benign or malignant (table 1). These tumors can arise from either the major salivary glands (parotid, submandibular, and sublingual (figure 1)) or the minor salivary glands, which are located throughout the submucosa of the mouth and upper aerodigestive tract, including the oral cavity (especially the palate), paranasal sinuses, larynx, and pharynx.
Salivary gland tumors are rare, and information on management is based mainly upon retrospective series, although in the last few years, a concerted effort has led to the completion of several prospective phase II trials, particularly in adenoid cystic carcinoma. The most common malignant salivary gland tumors include mucoepidermoid carcinoma, adenoid cystic carcinoma, polymorphous low-grade adenocarcinoma, carcinoma ex pleomorphic adenoma, acinic cell carcinoma, and adenocarcinoma not otherwise specified.
The treatment of locoregionally recurrent and metastatic salivary gland tumors is reviewed here. The initial treatment of locoregional disease and the epidemiology, risk factors, pathology, and clinical features of these tumors are discussed separately. (See "Salivary gland tumors: Treatment of locoregional disease" and "Salivary gland tumors: Epidemiology, diagnosis, evaluation, and staging".)
LOCOREGIONALLY RECURRENT DISEASE
Treatment options for recurrent salivary gland tumors, as with recurrent head and neck cancer in general, are limited by the previous therapy received and the potential resectability of recurrent disease. (See "Treatment of locally recurrent squamous cell carcinoma of the head and neck".)
Treatment of recurrent pleomorphic adenoma (benign mixed tumor) is discussed separately. (See "Salivary gland tumors: Treatment of locoregional disease", section on 'Pleomorphic adenoma'.)
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