Management of Regional Metastases of Malignant Salivary Gland Neoplasms.

Metastases from salivary gland carcinomas to the cervical lymph nodes are relatively uncommon. However, their impact on prognosis is significant and, thus, it is important to manage them appropriately. Treatment of clinically evident metastases consists primarily of surgery, frequently followed by radiation. Management of the N0 neck, on the other hand, remains controversial. While there seems to be agreement regarding the tumor and patient factors that make it more likely for a patient to harbor subclinical metastases in the lymph nodes, some clinicians prefer to treat those patients with surgery, i.e. a neck dissection, and others prefer to use elective radiation. These different approaches and their rationale will be discussed in detail.