Current management of salivary gland tumors. Part 2.

The authors base their treatment of salivary gland malignancies on the size of the primary and the histopathologic diagnosis. Group 1 includes smaller tumors in the T1 and T2 classification with cell types that are associated with slow growth. A parotidectomy is usually sufficient therapy for tumors in this group. Group 2 contains T1 and 2 tumors with more aggressive behavior. Total parotidectomy is indicated here, with postoperative radiotherapy. T3 tumors and patients with nodal metastasis or recurrent tumors make up group 3. Radical parotidectomy with sacrifice of the facial nerve is usually required for a sufficient tumor-free margin in these patients, and postop radiotherapy is also necessary. Group 4 includes T4 lesions. Extent of disease dictates magnitude of excision and amount of postop radiotherapy.