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. 2025 Sep 23;10(5):e70246.
doi: 10.1002/lio2.70246. eCollection 2025 Oct.

Practice Patterns in Management of Low- to Intermediate-Grade Salivary Gland Carcinoma: A Multi-Institutional Study

Mirabelle Sajisevi  1 , Kenny Nguyen  2 , Peter Callas  2 , Andrew J Holcomb  3 , Emre Vural  4 , Kyle P Davis  5 , Carissa M Thomas  6 , John S Stein  6 , Ameya Asarkar  7 , Ricardo Aulet  8 , Rebecca K Bell  9 , Michael A Blasco  10 , Vanessa B Bowmaster  11 , Clayton P Burruss  12 , Jeffson Chung  13 , Kimberly Chan  14 , Brent A Chang  15 , Charles S Coffey  16 , David M Cognetti  17 , Dylan J Cooper  10 , Joehassin Cordero  18 , John Donovan  19 , Yue Jennifer Du  20 , Yusuf Dundar  18 , Rogerio Dedivitis  21 , Heather Edwards  22 , Boban M Erovic  23 , Antoine Eskander  24   25 , Philip A Feinberg  26 , Emily A Garvey  27 , David Goldstein  28 , Joseph F Goodman  29 , Rafael N Goulart  30 , Neerav Goyal  14 , Stefan Grasl  31 , Jonathan Giurintano  32 , Nikita Gupta  12 , Andy Habib  32 , Trevor Hackman  33 , Jared H Hara  34 , Christina Henson  35 , Michael L Hinni  15 , Nadia Hua  36 , Stephanie Johnson-Obaseki  36 , Aditya Juloori  34 , Noah S Kalman  37 , Alexandra Kejner  38 , Sobia F Khaja  39 , Jamie A Ku  40 , Arnaud Lambert  41 , Bao K Luu  16 , Kelly R Magliocca  42 , Luiz R Medina Dos Santos  30 , Cara Michael  22 , Brett Miles  10 , Giulianno Molina de Melo  43   44 , Michael G Moore  45 , Gregoire B Morand  41 , Kauê Moura  46 , Hesameddin Noroozi  28 , Rusha Patel  47 , Joseph Paydarfar  9 , Karolina A Plonowska-Hirschfeld  48 , Nader Sadeghi  41 , Fabrice Savaria  49 , Nicole C Schmitt  50 , Justin Shapiro  51 , Timothy B Shaver  29 , Sandro J Stoeckli  49 , William Alvo Stokes  13 , Anita Sulibhavi  52 , Jason Tasoulas  33 , Varun Vendra  52 , Daniel B Vinh  45 , Celina G Virgen  53 , Neil M Woody  54 , Geoffrey D Young  37 , Kiran Kakarala  53 , Danny J Enepekides  24 , Michael P Hier  55 , Louise Davies  56 , William R Ryan  48
Affiliations

Practice Patterns in Management of Low- to Intermediate-Grade Salivary Gland Carcinoma: A Multi-Institutional Study

Mirabelle Sajisevi et al. Laryngoscope Investig Otolaryngol. .

Abstract

Objectives: To characterize practice patterns and outcomes in the management of low- and intermediate-grade salivary gland carcinoma prior to the existence of treatment guidelines.

Methods: Analysis of a registry of patients who underwent parotid and submandibular gland resections for low-and intermediate-grade carcinomas between 2010 and 2019.

Results: Of all 786 patients included in the study, 726 (92%) had preoperative imaging and 653 (83%) had preoperative biopsy. Of the 729 patients with parotid gland cancer, the majority underwent superficial (n = 384, 53%) or total (n = 254, 35%) parotidectomy. In patients with facial nerve preservation, total parotidectomy was associated with a significant increase in transient facial weakness (72/177 (41%) vs. 82/311 (26%), RR 0.65, 95% CI 0.50-0.84, p < 0.05) and permanent facial nerve weakness (23/176 (13%) vs. 16/301 (5%), RR 0.41, 95% CI 0.22-0.75, p < 0.05) compared to superficial parotidectomy. Adjuvant radiation therapy (RT) was delivered to 285 (36%) patients. The proportion of patients receiving adjuvant RT declined significantly over the time period from 2015 to 2019 compared to 2010 to 2014 at 162/504 (32%) and 123/282 (44%), respectively (RR 0.74, 95% CI 0.61-0.89, p < 0.05). When comparing the time periods from 2015 to 2019 and 2010 to 2014, there was no significant difference in local control rates (RR 0.52, 95% CI 0.26-1.04, p = 0.06) or regional control rates (RR 0.75, 95% CI 0.26-2.13, p = 0.58).

Conclusions: Management of low- and intermediate-grade salivary cancer from 2010 to 2019 was variable, which is expected given the rarity and heterogeneity of the disease and the lack of treatment guidelines prior to 2021. Most patients with parotid malignancies underwent superficial or total parotidectomy. The extent of parotidectomy had an impact on facial nerve function outcomes. Delivery of adjuvant radiation trended down with time. The data presented here will support dissemination of the guidelines and provide data that could inform future trials.

Level of evidence: 2b.

Keywords: facial nerve outcomes; guidelines; guidelines dissemination; major salivary gland cancer; practice patterns.

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Conflict of interest statement

The authors declare no conflicts of interest.

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