Is Preserving Submandibular Gland in Early Oral Squamous Cell Carcinoma Oncologically Safe?

The aim of the study was to assess the involvement of submandibular gland in oral cancer patients undergoing neck dissection. This study reviewed the records and pathologic specimens of patients who were clinically and histopathologically diagnosed as having oral cavity squamous cell carcinoma, from the year 2018 to 2023. A total of 332 patients were included. These patients underwent surgery with primary tumor resection and neck dissection. Pathologic metastasis to submandibular gland was then evaluated. Histopathological data showed that submandibular gland was involved in only 10 cases. Out of these cases, involvement of level IA &B lymph nodes was found in 9 of the cases. Direct extension of primary tumor to submandibular gland was noted in advanced stages (stage IV). Most common primary site for involvement of SMG was buccal mucosa (six patients), with significant correlation with LVI, ENE, DOI and WPOI (p value < 0.05). This study demonstrates that the incidence of submandibular gland metastasis in oral cavity (SCC) is extremely rare. Its involvement is either through direct extension from a primary lesion or in advanced disease. Thus, patients with early-stage oral SCC with preoperative N0 neck, may be candidates for preservation of the submandibular gland.