This protocol covers resectable sublingual gland cancer in patients with clinically or radiologically positive cervical lymph nodes (cN+) and no evidence of distant metastasis (M0).

Clinical Scenario

Surgery is the mainstay of treatment for primary resectable sublingual gland cancer. In the presence of clinically or radiologically positive cervical lymph nodes, a comprehensive therapeutic neck dissection is carried out alongside primary tumour resection.

This scenario — node-positive (cN+), non-metastatic disease — defines the post-operative management path detailed in this protocol.

Post-Operative Approach (Overview)

Following surgical resection, post-operative radiotherapy directed to the primary tumour region and the involved neck is a central component of management in this cN+ setting. The complete structured regimen — including field definitions, fractionation, and dose specifications — is available in the full protocol.

References

DOI: 10.1016/j.esmoop.2022.100602

Surgery is the mainstay of treatment for primary resectable disease with the traditional open approach being the most widely used, although endoscopic and robot-assisted approaches have recently been described.
When carrying out therapeutic neck dissection for clinically or radiologically positive lymph nodes (cN+), the recommendation is to carry out a comprehensive neck dissection of levels I-V.
Post-operative RT is indicated for all cases of pN+ neck.
After incomplete resection, a dose of 33 x 2 Gy is described for the primary tumour region plus a 1 cm margin, with 30 x 2 Gy after a clear resection.
A dose of 30 x 2 Gy is recommended for the involved level, and 33 x 2 Gy in case of extranodal disease.

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Treatment of Resectable Sublingual Gland Cancer with Positive Cervical Lymph Nodes (cN+)

References