Tumors of the major and minor salivary glands

Surgery for salivary gland tumors requires technical skill, competence in head and neck anatomy, and a familiarity with a variety of tumors. Benign salivary tumors at all sites should be 100 percent curable, with a local recurrence rate of less than five percent; these local failures should be curable with further surgery. The majority of parotid tumors are benign. Sixty-two percent of patients with malignant parotid tumors will be alive at five years, 54 percent at 10 years, and 47 percent at 15 years. These survival rates for malignant parotid tumors are better than those for malignant tumors in the submaxillary and minor salivary glands and may be explained in part by the presence of a higher percentage of low-grade malignant tumors in the parotid gland. Since most submaxillary gland tumors are malignant, they are more dangerous than parotid tumors. A total of 80 percent of patients with submaxillary gland tumors die as a result of cancer. Almost all minor salivary gland tumors are malignant; curability relates to size, local extension, histology, and nodal metastases. Forty-five percent are alive at five years, and 21 percent at 15 years. Wide-field radical surgical excision is needed for malignant salivary tumors to minimize local recurrences and treatment failures. Future improvement in treatment results will be made possible by increased awareness of this group of tumors, earlier diagnosis when tumors are still small, more radical extirpation, and greater use of postoperative radiation therapy.