Oral oncology · 2026
Can the submandibular gland be preserved during neck dissection in patients with oral squamous cell carcinoma？A systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Dou Ke, Liu Die, Shi Yue, Qin Haiyan, Zhao Zhiguo
Аннотация
OBJECTIVE: To evaluate the frequency of submandibular gland (SMG) involvement in oral squamous cell carcinoma (OSCC) and compare recurrence rates between neck dissection with and without SMG preservation.
METHODS: A comprehensive search of PubMed, Web of Science, Embase, and CENTRAL was conducted through October 1, 2025. Two reviewers independently performed study screening, data extraction, and risk-of-bias assessment. Data synthesis utilized fixed- and random-effects models, with heterogeneity quantified via the I2 statistic.
RESULTS: The final analysis included 41 studies comprising 7,667 patients. Assessment of SMG involvement in 39 studies (7,492 patients) identified 160 cases, yielding a pooled frequency of 1.55%. Involvement primarily resulted primarily direct extension by the primary tumor (99 cases; 0.83%) or extranodal extension (56 cases; 0.28%); intraglandular metastasis was rare. Subgroup analysis of 76 cases with reported T-stage indicated that 90.34% occurred in T3-T4 disease, compared to 9.66% in T1-T2. Similarly, among 70 cases with reported nodal status, 93.07% were N1-N3, versus 6.93% at N0. Five studies (861 patients) comparing preservation and excision revealed that there was no statistically significant difference in recurrence rates between the groups (RR = 1.11; 95% CI, 0.69-1.79; I2 = 12.3%).
CONCLUSIONS: SMG involvement in OSCC is uncommon and predominantly associated with direct extension in advanced-stage disease. SMG preservation appears feasible in early-stage (T1-T2, N0) OSCC, showing low involvement rates and no significant increase in recurrence risk. Given the low certainty of evidence, these findings require cautious interpretation and validation through prospective studies.
METHODS: A comprehensive search of PubMed, Web of Science, Embase, and CENTRAL was conducted through October 1, 2025. Two reviewers independently performed study screening, data extraction, and risk-of-bias assessment. Data synthesis utilized fixed- and random-effects models, with heterogeneity quantified via the I2 statistic.
RESULTS: The final analysis included 41 studies comprising 7,667 patients. Assessment of SMG involvement in 39 studies (7,492 patients) identified 160 cases, yielding a pooled frequency of 1.55%. Involvement primarily resulted primarily direct extension by the primary tumor (99 cases; 0.83%) or extranodal extension (56 cases; 0.28%); intraglandular metastasis was rare. Subgroup analysis of 76 cases with reported T-stage indicated that 90.34% occurred in T3-T4 disease, compared to 9.66% in T1-T2. Similarly, among 70 cases with reported nodal status, 93.07% were N1-N3, versus 6.93% at N0. Five studies (861 patients) comparing preservation and excision revealed that there was no statistically significant difference in recurrence rates between the groups (RR = 1.11; 95% CI, 0.69-1.79; I2 = 12.3%).
CONCLUSIONS: SMG involvement in OSCC is uncommon and predominantly associated with direct extension in advanced-stage disease. SMG preservation appears feasible in early-stage (T1-T2, N0) OSCC, showing low involvement rates and no significant increase in recurrence risk. Given the low certainty of evidence, these findings require cautious interpretation and validation through prospective studies.