Research progress in diagnosis and treatment of salivary gland tumors

  • Guangyan YU ,
  • Xin PENG ,
  • Min GAO ,
  • Peng YE ,
  • Na GE ,
  • Mengqi JIA ,
  • Bingyu LI ,
  • Zunan TANG ,
  • Leihao HU ,
  • Wenbo ZHANG
Expand
  • Department of Oral & Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
YU Guangyan, e-mail, gyyu@263.net
PENG Xin, e-mail, pxpengxin@263.net

Received date: 2024-10-30

  Online published: 2025-01-25

Supported by

the National Natural Science Foundation of China(39270723);the National Natural Science Foundation of China(30572050);the National Natural Science Foundation of China(30640093);the National Natural Science Foundation of China(82270993)

Copyright

, 2025, All rights reserved, without authorization

Abstract

Salivary gland tumor is one of the most common tumors in oral and maxillofacial regions. The diagnosis and treatment of salivary gland tumors had been a clinical characteristic project in Peking University School and Hospital of Stomatology since long time ago. Here we introduced the research progress in diagnosis and treatment of salivary gland tumors during the past 10 years. Among 7 190 cases of salivary gland tumors treated in this institution, 4 654 cases (64.7%) were benign, and 2 536 (35.3%) were malignant, with benign ∶ malignant ratio of 1.84 ∶ 1. Parotid was the most common location, followed by minor salivary gland and submandibular gland, while sublingular gland tumor was seldom seen. The proportion of minor salivary gland tumor was relatively high. Among 1 874 cases with primary malignant tumors, the cases with T3 and stage Ⅲ accounted for only 9.6% and 10.3%, respectively, which indicated that there was shortcoming in the T classification and clinical stage formulated by Union for International Cancer Control (UICC), and further revision was required. The 5, 10, and 15 year survival rates of 1 637 cases with postoperative follow-up were 93.1%, 87.2% and 79.3%, respectively, which were much higher than those we reported 30 years ago. The improvement of treatment results was related to more widely used combined treatment with surgery and postoperative radiotherapy, and the increase in patients with early stage. Adenoid cystic carcinoma was the malignant tumor with high rate of distant metastasis. The 5 and 10 year survival rates of the patients with pulmonary metastasis were 76.2% and 51.8%, respectively, which indicated that the pulmonary metastatic carcinomas developed slowly. Recurrent rate of carcinoma ex pleomorphic adenoma was 46.7% after single treatment of sur-gery, while it decreased to 27.5% after combined theraphy with surgery and radiotherapy, indicating that postoperative radiotheraphy could reduce the recurrent rate effectively. The normal myoepithelial cells had the inhibiting role in the invasion and metastasis of carcinoma ex pleomorphic adenoma. The evaluation of integrity of myoepithelial cells surrounding the tumor mass is helpful to understand the invasiveness of the tumors. The new surgical modalities such as extracapsular resection and partial sialoadenectomy were used in treatment of benign tumors of parotid gland and submandibular gland with advantages of decreased tissue damage and preservation of glandular function. Application of digital surgical techniques such as mixed reality combined with surgical navigation and real-time three-dimensional holograms in the surgical treatment of parotid gland tumors showed the benifits of more safety and precision, and less tissue da-mage.

Cite this article

Guangyan YU , Xin PENG , Min GAO , Peng YE , Na GE , Mengqi JIA , Bingyu LI , Zunan TANG , Leihao HU , Wenbo ZHANG . Research progress in diagnosis and treatment of salivary gland tumors[J]. Journal of Peking University(Health Sciences), 2025 , 57(1) : 1 -6 . DOI: 10.19723/j.issn.1671-167X.2025.01.001

References

1 于世凤. 口腔组织病理学[M]. (6版) 北京: 人民卫生出版社, 2007.
2 俞光岩, 马大权. 北京大学口腔医院唾液腺肿瘤研究50年回顾[J]. 北京大学学报(医学版), 2015, 47 (1): 1- 7.
3 Gao M , Hao Y , Huang MX , et al. Salivary gland tumours in a northern Chinese population: A 50-year retrospective study of 7 190 cases[J]. Int J Oral Maxillofac Surg, 2017, 46 (3): 343- 349.
4 Seifert G , Mieblke A , Haubrich J . Diseases of salivary glands: Pathology-diagnosis-treatment-facial nerve surgery[M]. Stuttgart: Geory Thieme Verlag, 1986: 393.
5 Eveson JW , Cawson RA . Salivary gland tumors: A review of 2 410 cases with particular reference to histological types, site, age, and distribution[J]. J Pathol, 1985, 146 (1): 51- 58.
6 Sobin LH , Gospodarowicz MK , Wittekind CH . International Union Against Cancer (UICC) TNM classification of malignant tumours[M]. 7th ed Chichester: Wiley-Blackwell, 2010.
7 Jia MQ , Gao M , Ye P , et al. Survival outcome of salivary gland carcinoma: A 50-year retrospective study with long-term follow-up[J]. J Oral Maxillofac Surg, 2022, 80 (12): 2003- 2014.
8 Yu GY , Ma DQ . Carcinoma of the salivary glands: A clinico-pathologic study of 405 cases[J]. Semin Surg Oncol, 1987, 3 (4): 240- 244.
9 Gao M , Hao Y , Huang MX , et al. Clinicopathologic study of distant metastases of salivary adenoid cystic carcinoma[J]. Int J Oral Maxillofac Surg, 2013, 42 (8): 923- 928.
10 Eneroth CM , Zetterberg A . Malignancy in pleomorphic adenoma. A clinical and microspectrophotometric study[J]. Acta Otolaryngol, 1974, 77 (6): 426- 432.
11 Ye P , Gao Y , Mao C , et al. Carcinoma ex pleomorphic adenoma: Is it a high-grade malignancy?[J]. J Oral Maxillofac Surg, 2016, 74 (10): 2093- 2104.
12 Weissferdt A , Moran CA . Pulmonary salivary gland-type tumors with features of malignant mixed tumor (carcinoma ex pleomorphic adenoma): A clinicopathologic study of five cases[J]. Am J Clin Pathol, 2011, 136 (5): 793- 798.
13 Ye P , Gao Y , Wei T , et al. Absence of myoepithelial cells correlates with invasion and metastasis of carcinoma ex pleomorphic adenoma[J]. Int J Oral Maxillofac Surg, 2017, 46 (8): 958- 964.
14 李炳雨, 唐祖南, 胡耒豪, 等. 腮腺微小肿瘤的临床病理研究[J]. 北京大学学报(医学版), 2022, 54 (2): 335- 339.
15 Mao Y , Lee B , Sun Z , et al. The efficacy of clinicopatholo-gical and imaging features in differentiating benign from malignant parotid micro- and minitumors: A retrospective analysis[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2024, 138 (3): 440- 452.
16 高敏, 陈艳, 高岩, 等. 紧贴面神经的腮腺多形性腺瘤的临床病理特点及处理[J]. 北京大学学报(医学版), 2012, 44 (1): 43- 46.
17 Xu H , Mao C , Liu JM , et al. Microanatomic study of the vascular and duct system of the submandibular gland[J]. J Oral Maxillofac Surg, 2011, 69 (4): 1103- 1107.
18 Ge N , Peng X , Zhang L , et al. Partial sialoadenectomy for treatment of benign tumors in the submandibular gland[J]. Int J Oral Maxillofac Surg, 2016, 45 (6): 750- 755.
19 Tang ZN , Hu LH , Yu Y , et al. Mixed reality combined with surgical navigation in resection of micro- and mini-tumors of the paro-tid gland: A pilot study[J]. Laryngoscope, 2024, 134 (4): 1670- 1678.
20 Hu LH , Yu Y , Tang ZN , et al. Direct visualization of intraparotid facial nerve assisting in parotid tumor resection[J]. J Cranio-maxillofac Surg, 2024, 52 (5): 659- 665.
Outlines

/