Diagnostic and therapeutic modalities for 287 malignant and benign salivary tumors: a cohort study

Abstract Background Salivary gland tumors (SGT's), 3-10% of head/neck tumors, exhibit a striking range of morphological diversity. This minimally symptomatic disease can be challenging to diagnose, and therapeutic policy is still controversial. Methods We compared benign and malignant cohorts according to diagnostic modality utilized and therapeutic modality administered over 20 years in a single medical center. Results Of 287 cases, 216 had benign tumors and 71 had malignant tumors. Treatment was surgery-based in 99% of cases, often accompanied by radiotherapy and/or chemotherapy. Rates of imaging and biopsy for diagnosis were significantly higher in malignant than benign tumors. Fine-needle aspiration (FNA) was used in 90.3% of benign tumors. Of 71 malignant tumors, 69 underwent surgery to fully remove the malignant tumor. Adjuvant therapy included 22 neck dissections (30%), 28 radiotherapy (39.4%), 12 chemotherapy (16.9%) and 10 combined radio-chemotherapy (14.1%). Partial parotidectomy, submandibular sialoadencetomy and local excision were used in 78.1%, 8.3% and 6.9% of benign cases. Total parotidectomy, sub-total maxillectomy and wide excision were used in 16.9%, 12.7% and 22.6% of malignant cases. Discussion Diagnostic and therapeutic modalities for treatment of salivary tumor at our hospital are presented and discussed with respect to others. A paradigm of therapy administered in our institute is presented.