Submandibular gland involvement in early stage oral cavity carcinomas: can the gland be left behind?

OBJECTIVE To determine the frequency of submandibular gland involvement in early oral cavity tumors. STUDY DESIGN Observational study. PLACE AND DURATION OF STUDY ENT Department, CMH, Rawalpindi, from January 2008 to December 2011. METHODOLOGY Data of 110 oral cavity tumors operated over 2008 - 2011 was retrieved from ENT OPD, tumor registry in AFIP and from Head and Neck Oncology Forum Registry. Cases of oral cavity tumors that had undergone elective neck dissections were retrospectively studied for invasion of the submandibular gland, TNM Staging, perineural, perivascular, lymphovascular invasion, site specific frequency of oral cavity tumors and frequency of lymph node metastasis. RESULTS Tumors of tongue were the most common constituting 42%, squamous cell carcinoma was the histological diagnosis in 90% cases. Sixty eight (61.8%) cases were node negative. Selective neck dissection was done in 55.5% of the cases. Submandibular gland was involved in 2 cases (1.8%). CONCLUSION Submandibular gland metastasis from early oral cavity tumors is rare; any neoplastic involvement of the gland usually occurs via direct spread.