A large case series from a literature review included 2,750 patients with OSCC, and only 2 patients (0.07%) had intraglandular lymph node metastases ( 8). According to the 2013 edition of the neck nodal classification in the neck, SMG is one of the contents of level IB ( 7). The submandibular gland (SMG), which is located in the submandibular triangle, has the predominant function of saliva secretion. Therefore, primary surgery and neck dissection remain the most important management for OSCC ( 6). In patients with early-stage (T1) and clinically lymph node-negative disease, 23% of them had occult lymph node metastasis during neck dissection ( 5). Approximately 29%–36% of oral squamous cell carcinoma (OSCC) patients had cervical lymph node involvement ( 3, 4). The majority of oral cavity cancers are squamous cell carcinoma (SCC) ( 2). Preservation of the SMG during neck dissection in selected patients with OSCC seems to be feasible and oncologically safe.Īccording to the GLOBOCAN 2020, cancers developed in the lip and oral cavity accounted for approximately 2% of all cancers in the world, with over 370,000 cases newly diagnosed with lip and oral cavity cancers and 170,000 disease-related deaths occurring annually ( 1). Patients with tumors located in the buccal mucosa and N3 stage were the independent predictive factors associated with level IB nodal metastasis.Ĭonclusion: Involvement of SMG in OSCC is quite rare. There were 6 lymph nodes located in the lateral part of the SMG and 12 lymph nodes located in the anterior of the SMG. A total of 18 positive lymph nodes were found in level IB in 16 patients, and no positive lymph nodes were located in the SMG. Of these patients, only one patient (0.7%) had involvement in SMG by directly infiltrating from the primary tumor. All patients had level IB lymph node dissection and simultaneous removal of the SMG. Results: We included 145 patients who underwent primary surgery and neck dissection in this study. The distribution of lymph nodes metastasis in level IB was analyzed. Methods: Patients initially diagnosed with OSCC between January 2018 and October 2020 were included. This study aimed to investigate the incidence and the patterns of SMG involvement in OSCC patients. Purpose: In the current recommendation of neck dissection in oral squamous cell carcinoma (OSCC), the submandibular gland (SMG) should also be removed. 3Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, China.2Department of Stomatology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China.1Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen, China.Ping Zhou 1†, Jing-Xin Chen 2†, Yuan Zhou 1†, Chen-Lu Lian 1, Bing Yan 3* and San-Gang Wu 1*
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