Evaluation of submandibular gland involvement in oral squamous cell carcinoma patients / Preveena Balakrishnan

Preveena , Balakrishnan (2024) Evaluation of submandibular gland involvement in oral squamous cell carcinoma patients / Preveena Balakrishnan. Masters thesis, Universiti Malaya.

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Abstract

Background: The oncological necessity for the excision of the submandibular gland (SMG) in neck dissection of oral squamous cell carcinoma (OSCC) management remains a debate. Although it is routinely excised in neck dissection, literature on the actual indication for removal is limited. Aim: This study aims to analyse the frequency of SMG involvement in OSCC patients and the impact of its removal on the survival status of these patients. Objectives: To investigate the prevalence of SMG in OSCC patients and to analyse the association between the involvement of SMG and the status of Ib lymph node involvement. Next was to analyse the association between the overall survival (OS) and disease-free survival (DFS) of patients with OSCC and the involvement of SMG. Methods: Retrospective data of patients diagnosed with OSCC between 2000 to 2020 and who underwent neck dissection were included and analysed. Descriptive studies were used to analyse the prevalence. Pearson Chi-Square test was done to analyse the association between SMG and level Ib lymph node. Kaplan-Meir and the log-rank test were used for the survival analysis. Results: A total of 142 patients were included in this study. The prevalence of SMG involvement was 3.52% (95% CI). There was no statistically significant association between the SMG and level Ib lymph node status. The 5-year OS status in patients with SMG-positive and negative was 60% and 88.8% respectively (p-value = 0.013). The 5-year DFS status for SMG-positive and negative was 80% and 95.8% (p-value < 0.001). The SMG status has a significant influence on the OS and the DFS of patients with SMG involvement. Conclusions: The involvement of SMG in OSCC cases is rare. The status of the level Ib lymph node does not significantly influence the SMG status. The status of SMG involvement in OSCC cases has significant impact on the OS and DSF and is reason enough to explore the option of preserving the SMG in selected cases. To learn more about the oncological safety and actual impact of SMG preservation on quality of life, prospective research in the future is warranted.

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