Salivary gland cancer: ESMO-European Reference Network on Rare Adult Solid Cancers (EURACAN) Clinical Practice Guideline for diagnosis, treatment and follow-up

C van Herpen¹, V Vander Poorten², A Skalova³, C Terhaard⁴, R Maroldi⁵, A van Engen⁶, B Baujat⁷, L D Locati⁸, A D Jensen⁹, L Smeele¹⁰, J Hardillo¹¹, V Costes Martineau¹², A Trama¹³, E Kinloch¹⁴, C Even¹⁵, J-P Machiels¹⁶; ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org

Affiliations

¹ Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands; Multidisciplinary Salivary Gland Society, Geneva, Switzerland. Electronic address: https://twitter.com/myESMO.
² Multidisciplinary Salivary Gland Society, Geneva, Switzerland; Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven; Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.
³ Multidisciplinary Salivary Gland Society, Geneva, Switzerland; Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen, Czech Republic.
⁴ Multidisciplinary Salivary Gland Society, Geneva, Switzerland; Department of Radiotherapy, University Medical Center, Utrecht, The Netherlands.
⁵ Department of Radiology, ASST Spedali Civili Brescia-University of Brescia, Brescia, Italy.
⁶ Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
⁷ Department of Otorhinolaryngology, Head and Neck Surgery, Sorbonne Université Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Paris, France.
⁸ Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
⁹ Faculty of Medicine, Philipps-University Marburg, Marburg; Department of Radiation Oncology, University Hospitals Gießen and Marburg (UKGM) Ltd, Gießen, Germany.
¹⁰ Department of Head and Neck Oncology and Surgery, Antoni van Leeuwenhoek Ziekenhuis & Amsterdam UMC, Amsterdam.
¹¹ Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
¹² Department of Pathology, CHU Montpellier, Montpellier, France.
¹³ Evaluative Epidemiology, Department of Research, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy.
¹⁴ Salivary Gland Cancer UK, London, UK.
¹⁵ Head and Neck Department, Gustave Roussy, Paris; French Network for Rare Head and Neck Cancers, Paris, France.
¹⁶ Service d'Oncologie Médicale, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, Brussels; Institut de Recherche Clinique et Expérimentale, Université Catholique de Louvain (UCLouvain), Brussels, Belgium.

PMID: 36567082
PMCID: PMC9808465
DOI: 10.1016/j.esmoop.2022.100602

Practice Guideline

Salivary gland cancer: ESMO-European Reference Network on Rare Adult Solid Cancers (EURACAN) Clinical Practice Guideline for diagnosis, treatment and follow-up

C van Herpen et al. ESMO Open. 2022 Dec.

. 2022 Dec;7(6):100602.

doi: 10.1016/j.esmoop.2022.100602. Epub 2022 Nov 2.

Authors

Affiliations

¹ Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands; Multidisciplinary Salivary Gland Society, Geneva, Switzerland. Electronic address: https://twitter.com/myESMO.
² Multidisciplinary Salivary Gland Society, Geneva, Switzerland; Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven; Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.
³ Multidisciplinary Salivary Gland Society, Geneva, Switzerland; Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen, Czech Republic.
⁴ Multidisciplinary Salivary Gland Society, Geneva, Switzerland; Department of Radiotherapy, University Medical Center, Utrecht, The Netherlands.
⁵ Department of Radiology, ASST Spedali Civili Brescia-University of Brescia, Brescia, Italy.
⁶ Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
⁷ Department of Otorhinolaryngology, Head and Neck Surgery, Sorbonne Université Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Paris, France.
⁸ Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
⁹ Faculty of Medicine, Philipps-University Marburg, Marburg; Department of Radiation Oncology, University Hospitals Gießen and Marburg (UKGM) Ltd, Gießen, Germany.
¹⁰ Department of Head and Neck Oncology and Surgery, Antoni van Leeuwenhoek Ziekenhuis & Amsterdam UMC, Amsterdam.
¹¹ Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
¹² Department of Pathology, CHU Montpellier, Montpellier, France.
¹³ Evaluative Epidemiology, Department of Research, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy.
¹⁴ Salivary Gland Cancer UK, London, UK.
¹⁵ Head and Neck Department, Gustave Roussy, Paris; French Network for Rare Head and Neck Cancers, Paris, France.
¹⁶ Service d'Oncologie Médicale, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, Brussels; Institut de Recherche Clinique et Expérimentale, Université Catholique de Louvain (UCLouvain), Brussels, Belgium.

PMID: 36567082
PMCID: PMC9808465
DOI: 10.1016/j.esmoop.2022.100602

Erratum in

Corrigendum to 'Salivary gland cancer: ESMO-European Reference Network on Rare Adult Solid Cancers (EURACAN) Clinical Practice Guideline for diagnosis, treatment and follow-up': [ESMO Open 7(6):100602, December 2022].
van Herpen C, Vander Poorten V, Skalova A, Terhaard C, Maroldi R, van Engen A, Baujat B, Locati LD, Jensen AD, Smeele L, Hardillo J, Costes Martineau V, Trama A, Kinloch E, Even C, Machiels JP; ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org. van Herpen C, et al. ESMO Open. 2023 Oct;8(5):101630. doi: 10.1016/j.esmoop.2023.101630. Epub 2023 Aug 23. ESMO Open. 2023. PMID: 37625197 Free PMC article. No abstract available.

Abstract

•
This ESMO–EURACAN Clinical Practice Guideline provides key recommendations for managing salivary gland cancer.
•
The guideline covers clinical and pathological diagnosis, staging and risk assessment, treatment and follow-up.
•
Treatment algorithms for parotid, submandibular, sublingual and minor salivary gland cancer are provided.
•
The author group encompasses a multidisciplinary group of experts from different institutions and countries in Europe.
•
Recommendations are based on available scientific data and the authors’ collective expert opinion.

Keywords: ESMO–EURACAN Clinical Practice Guideline; diagnosis; follow-up; salivary gland cancer; treatment.

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Figures

**Figure 1**
**Work-up of major salivary gland nodules.** Purple: general categories or stratification; white: other aspects of management. AdCC, adenoid cystic carcinoma; CNB, core needle biopsy; CT, computed tomography; FDG–PET–CT, [¹⁸F]2-fluoro-2-deoxy-D-glucose–positron emission tomography–computed tomography; FNA, fine-needle aspiration; MRI, magnetic resonance imaging. ^aCNB considered when FNA is non-diagnostic or if more histological information is required.

**Figure 2**
**Treatment algorithm for parotid gland cancer.** Purple: general categories or stratification; red: surgery; dark green: radiotherapy; white: other aspects of management; blue: systemic anticancer therapy. ChT, chemotherapy; CNB, core needle biopsy; END, elective neck dissection; ENI, elective neck irradiation; FNA, fine-needle aspiration; ND, node dissection; nVII, seventh nerve; RT, radiotherapy. ^aDefinition of high-grade tumours is described in Section 1 of the Supplementary Material, available at https://doi.org/10.1016/j.esmoop.2022.100602.

**Figure 3**
**Treatment algorithm for minor or sublingual SGC.** Purple: general categories or stratification; red: surgery; dark green: radiotherapy; white: other aspects of management; blue: systemic anticancer therapy. ChT, chemotherapy; END, elective neck dissection; ND, node dissection; RT, radiotherapy; SGC, salivary gland cancer. ^aDefinition of high-grade tumours is described in Section 1 of the Supplementary Material, available at https://doi.org/10.1016/j.esmoop.2022.100602.

**Figure 4**
**Treatment algorithm for submandibular gland cancer.** Purple: general categories or stratification; red: surgery; dark green: radiotherapy; white: other aspects of management; blue: systemic anticancer therapy. ChT, chemotherapy; CNB, core needle biopsy; FNA, fine-needle aspiration; ND, node dissection; RT, radiotherapy. ^aDefinition of high-grade tumours is described in Section 1 of the Supplementary Material, available at https://doi.org/10.1016/j.esmoop.2022.100602.

See this image and copyright information in PMC

References

1. Ferlay J., Ervik M., Lam F., et al. Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer. https://gco.iarc.fr/today Available at.
1. RARECARENet. Information Network on Rare Cancers. http://rarecarenet.istitutotumori.mi.it/ Available at.
1. Radoi L., Barul C., Menvielle G., et al. Risk factors for salivary gland cancers in France: results from a case-control study, the ICARE study. Oral Oncol. 2018;80:56–63. - PubMed
1. Lin H.H., Limesand K.H., Ann D.K. Current state of knowledge on salivary gland cancers. Crit Rev Oncog. 2018;23(3-4):139–151. - PMC - PubMed
1. Cong X. Air pollution from industrial waste gas emissions is associated with cancer incidences in Shanghai, China. Environ Sci Pollut Res Int. 2018;25(13):13067–13078. - PubMed

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Salivary gland cancer: ESMO-European Reference Network on Rare Adult Solid Cancers (EURACAN) Clinical Practice Guideline for diagnosis, treatment and follow-up

Affiliations

Salivary gland cancer: ESMO-European Reference Network on Rare Adult Solid Cancers (EURACAN) Clinical Practice Guideline for diagnosis, treatment and follow-up

Authors

Affiliations

Erratum in

Abstract

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References

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Full Text Sources

Medical