Parotid Gland Cancer: Resectable Recurrent Locoregional Disease Without Distant Metastasis

This protocol addresses patients with parotid gland cancer who develop locoregional recurrence that is amenable to surgical resection, with no evidence of distant metastatic spread.

Clinical scenario

Resectable recurrent locoregional salivary gland cancer, with no distant metastatic disease. The approach applies regardless of prior treatment type, with surgical resectability as the defining eligibility criterion.

Treatment approach

Management centres on revision surgical resection targeting clear margins, combined with appropriate reconstruction and rehabilitation. Neck management forms an integral part of the operative plan, with the specific indication and extent determined by nodal status… — the complete structured protocol, including all surgical decision points, is available via the link below.

Primary treatment goal

Achieving negative surgical margins — shown to improve overall survival in salivary gland cancer resection.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1200/JCO.21.00449

In the setting of resectable, recurrent locoregional disease and no distant metastatic disease, regardless of prior treatment type, patients should be offered revision resection and appropriate surgical reconstruction and rehabilitation.

Primary treatment of recurrent salivary gland cancer should begin with revision surgical resection to clear margins.

Comprehensive neck dissection of appropriate levels should be undertaken for all N1 disease.

Elective neck dissection of appropriate levels at risk should also be encouraged in the N0 neck in conjunction with revision surgery, although this is frequently required in conjunction with vessel access for appropriate reconstructive surgery.

When resecting salivary cancers, achieving negative surgical margins has been shown to improve OS.

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