Results of treatment for patients with salivary gland
carcinoma have improved in recent years, most likely due to earlier diagnosis and the use of more effective locoregional
therapy. Salivary gland
tumors are treated surgically, often in conjunction with postoperative
radiation therapy when the
tumor is malignant. Good results rest strongly on the performance of an adequate, en bloc initial resection.
Radical neck dissection in indicated in patients with obvious cervical
metastasis, and limited
neck dissection may be appropriate in patients with clinically negative nodes in whom occult nodal involvement is likely. Postoperative
radiation therapy should be administered when the
tumor is high stage or high grade, the adequacy of the resection is in question, or the
tumor has ominous pathologic features. Neutron beam
therapy shows promise in controlling locoregional disease but requires further study. No single chemotherapeutic agent or combination regimen has produced consistent results. At present,
chemotherapy is clearly indicated only for palliation in symptomatic patients with recurrent and/or unresectable
cancers. Patients with salivary gland
carcinomas must be followed for long periods, as recurrence may occur a decade or more following
therapy. Distant
metastasis appears to occur in approximately 20% of patients.