Indications for neck dissection or irradiation in submandibular gland cancers

  • Clinically/radiologically N+ neck: Modified radical neck dissection (Levels I-V)
  • Clinically/radiologically N0 neck
    • Elective treatment of the neck (Levels Ia,b, IIa and III )
    • Elective neck dissection and elective radiotherapy are equally effective
    • Known risk factors for occult neck disease are
      • Tumour size >4cm
      • High-grade histology
      • Extraglandular tumour extension
    • With a clinically or cytologically malignant tumour, electively clear all nodes in Level I to avoid having to redissect Level I
      • If positive on frozen section, proceed to modified neck dissection
      • If frozen section not available, then histology of lymph nodes guides subsequent treatment

Index: Clinical Practice Guidelines for Submandibular Gland

Resource Appropriate Submandibular Gland Guideline Scenarios