Evaluation of submandibular gland involvement in oral squamous cell carcinoma patients

In the management of oral squamous cell carcinoma (OSCC), neck dissection is essential for achieving loco-regional control. The submandibular gland (SMG) is frequently removed during this procedure, which may result in xerostomia and negatively affect postoperative quality of life. Although preservation of SMG could be beneficial, its oncological safety in OSCC remains uncertain. This retrospective, cross-sectional, multicentre study aimed to determine the prevalence of SMG involvement in OSCC, identify associated risk factors, and evaluate its impact on survival. Clinical and pathological data of OSCC patients diagnosed between 2000 and 2021 were analysed. Patients who did not undergo neck dissection, received neoadjuvant therapy, or had incomplete records were excluded. Data were obtained from the Malaysian Oral Cancer Database and Tissue Bank System. Survival outcomes were analysed using Kaplan-Meier estimates and log-rank tests. Among 223 included patients, SMG involvement was uncommon (n = 7, 3.1%). Most affected cases involved buccal mucosa OSCC and presented with advanced disease (cTNM stage IVa). SMG involvement was significantly associated with level Ib lymph node metastasis (P < 0.001) and extranodal extension (P = 0.013). No significant association was observed between SMG involvement and overall or disease-free survival. SMG preservation appears feasible in selected OSCC patients.