Practice Patterns in Management of Low- to Intermediate-Grade Salivary Gland Carcinoma: A Multi-Institutional Study

Mirabelle Sajisevi; Kenny Nguyen; Peter Callas; Andrew J. Holcomb; Emre Vural; Kyle P. Davis; Carissa M. Thomas; John S. Stein; Ameya Asarkar; Ricardo Aulet; Rebecca K. Bell; Michael A. Blasco; Vanessa B. Bowmaster; Clayton P. Burruss; Jeffson Chung; Kimberly Chan; Brent A. Chang; Charles S. Coffey; David M. Cognetti; Dylan J. Cooper; Joehassin Cordero; John Donovan; Yue Jennifer Du; Yusuf Dundar; Rogerio Dedivitis; Heather Edwards; Boban M. Erovic; Antoine Eskander; Philip A. Feinberg; Emily A. Garvey; David Goldstein; Joseph F. Goodman; Rafael N. Goulart; Neerav Goyal; Stefan Grasl; Jonathan Giurintano; Nikita Gupta; Andy Habib; Trevor Hackman; Jared H. Hara; Christina Henson; Michael L. Hinni; Nadia Hua; Stephanie Johnson-Obaseki; Aditya Juloori; Noah S. Kalman; Alexandra Kejner; Sobia F. Khaja; Jamie A. Ku; Arnaud Lambert; Bao K. Luu; Kelly R. Magliocca; Luiz R. Medina dos Santos; Cara Michael; Brett Miles; Giulianno Molina de Melo; Michael G. Moore; Gregoire B. Morand; Kauê Moura; Hesameddin Noroozi; Rusha Patel; Joseph Paydarfar; Karolina A. Plonowska-Hirschfeld; Nader Sadeghi; Fabrice Savaria; Nicole C. Schmitt; Justin Shapiro; Timothy B. Shaver; Sandro J. Stoeckli; William Alvo Stokes; Anita Sulibhavi; Jason Tasoulas; Varun Vendra; Daniel B. Vinh; Celina G. Virgen; Neil M. Woody; Geoffrey D. Young; Kiran Kakarala; Danny J. Enepekides; Michael P. Hier; Louise Davies; William R. Ryan

doi:10.1002/lio2.70246

Practice Patterns in Management of Low- to Intermediate-Grade Salivary Gland Carcinoma: A Multi-Institutional Study

Mirabelle Sajisevi
, Kenny Nguyen
, Peter Callas
, Andrew J. Holcomb
, Emre Vural
, Kyle P. Davis
, Carissa M. Thomas
, John S. Stein
, Ameya Asarkar
, Ricardo Aulet
, Rebecca K. Bell
, Michael A. Blasco
, Vanessa B. Bowmaster
, Clayton P. Burruss
, Jeffson Chung
, Kimberly Chan
, Brent A. Chang
, Charles S. Coffey
, David M. Cognetti
, Dylan J. Cooper

Joehassin Cordero, John Donovan, Yue Jennifer Du, Yusuf Dundar, Rogerio Dedivitis, Heather Edwards, Boban M. Erovic, Antoine Eskander, Philip A. Feinberg, Emily A. Garvey, David Goldstein, Joseph F. Goodman, Rafael N. Goulart, Neerav Goyal, Stefan Grasl, Jonathan Giurintano, Nikita Gupta, Andy Habib, Trevor Hackman, Jared H. Hara, Christina Henson, Michael L. Hinni, Nadia Hua, Stephanie Johnson-Obaseki, Aditya Juloori, Noah S. Kalman, Alexandra Kejner, Sobia F. Khaja, Jamie A. Ku, Arnaud Lambert, Bao K. Luu, Kelly R. Magliocca, Luiz R. Medina dos Santos, Cara Michael, Brett Miles, Giulianno Molina de Melo, Michael G. Moore, Gregoire B. Morand, Kauê Moura, Hesameddin Noroozi, Rusha Patel, Joseph Paydarfar, Karolina A. Plonowska-Hirschfeld, Nader Sadeghi, Fabrice Savaria, Nicole C. Schmitt, Justin Shapiro, Timothy B. Shaver, Sandro J. Stoeckli, William Alvo Stokes, Anita Sulibhavi, Jason Tasoulas, Varun Vendra, Daniel B. Vinh, Celina G. Virgen, Neil M. Woody, Geoffrey D. Young, Kiran Kakarala, Danny J. Enepekides, Michael P. Hier, Louise Davies, William R. Ryan

Otolaryngology

Research output: Contribution to journal › Article › peer-review

Abstract

Objectives: To characterize practice patterns and outcomes in the management of low- and intermediate-grade salivary gland carcinoma prior to the existence of treatment guidelines. Methods: Analysis of a registry of patients who underwent parotid and submandibular gland resections for low-and intermediate-grade carcinomas between 2010 and 2019. Results: Of all 786 patients included in the study, 726 (92%) had preoperative imaging and 653 (83%) had preoperative biopsy. Of the 729 patients with parotid gland cancer, the majority underwent superficial (n = 384, 53%) or total (n = 254, 35%) parotidectomy. In patients with facial nerve preservation, total parotidectomy was associated with a significant increase in transient facial weakness (72/177 (41%) vs. 82/311 (26%), RR 0.65, 95% CI 0.50–0.84, p < 0.05) and permanent facial nerve weakness (23/176 (13%) vs. 16/301 (5%), RR 0.41, 95% CI 0.22–0.75, p < 0.05) compared to superficial parotidectomy. Adjuvant radiation therapy (RT) was delivered to 285 (36%) patients. The proportion of patients receiving adjuvant RT declined significantly over the time period from 2015 to 2019 compared to 2010 to 2014 at 162/504 (32%) and 123/282 (44%), respectively (RR 0.74, 95% CI 0.61–0.89, p < 0.05). When comparing the time periods from 2015 to 2019 and 2010 to 2014, there was no significant difference in local control rates (RR 0.52, 95% CI 0.26–1.04, p = 0.06) or regional control rates (RR 0.75, 95% CI 0.26–2.13, p = 0.58). Conclusions: Management of low- and intermediate-grade salivary cancer from 2010 to 2019 was variable, which is expected given the rarity and heterogeneity of the disease and the lack of treatment guidelines prior to 2021. Most patients with parotid malignancies underwent superficial or total parotidectomy. The extent of parotidectomy had an impact on facial nerve function outcomes. Delivery of adjuvant radiation trended down with time. The data presented here will support dissemination of the guidelines and provide data that could inform future trials. Level of Evidence: 2b.

Original language	English (US)
Article number	e70246
Journal	Laryngoscope investigative otolaryngology
Volume	10
Issue number	5
DOIs	https://doi.org/10.1002/lio2.70246
State	Published - Oct 2025

Bibliographical note

Publisher Copyright:
© 2025 The Author(s). Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.

Keywords

facial nerve outcomes
guidelines
guidelines dissemination
major salivary gland cancer
practice patterns

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1002/lio2.70246

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Sajisevi, M., Nguyen, K., Callas, P., Holcomb, A. J., Vural, E., Davis, K. P., Thomas, C. M., Stein, J. S., Asarkar, A., Aulet, R., Bell, R. K., Blasco, M. A., Bowmaster, V. B., Burruss, C. P., Chung, J., Chan, K., Chang, B. A., Coffey, C. S., Cognetti, D. M., ... Ryan, W. R. (2025). Practice Patterns in Management of Low- to Intermediate-Grade Salivary Gland Carcinoma: A Multi-Institutional Study. Laryngoscope investigative otolaryngology, 10(5), Article e70246. https://doi.org/10.1002/lio2.70246

Sajisevi, M, Nguyen, K, Callas, P, Holcomb, AJ, Vural, E, Davis, KP, Thomas, CM, Stein, JS, Asarkar, A, Aulet, R, Bell, RK, Blasco, MA, Bowmaster, VB, Burruss, CP, Chung, J, Chan, K, Chang, BA, Coffey, CS, Cognetti, DM, Cooper, DJ, Cordero, J, Donovan, J, Du, YJ, Dundar, Y, Dedivitis, R, Edwards, H, Erovic, BM, Eskander, A, Feinberg, PA, Garvey, EA, Goldstein, D, Goodman, JF, Goulart, RN, Goyal, N, Grasl, S, Giurintano, J, Gupta, N, Habib, A, Hackman, T, Hara, JH, Henson, C, Hinni, ML, Hua, N, Johnson-Obaseki, S, Juloori, A, Kalman, NS, Kejner, A, Khaja, SF, Ku, JA, Lambert, A, Luu, BK, Magliocca, KR, Medina dos Santos, LR, Michael, C, Miles, B, de Melo, GM, Moore, MG, Morand, GB, Moura, K, Noroozi, H, Patel, R, Paydarfar, J, Plonowska-Hirschfeld, KA, Sadeghi, N, Savaria, F, Schmitt, NC, Shapiro, J, Shaver, TB, Stoeckli, SJ, Stokes, WA, Sulibhavi, A, Tasoulas, J, Vendra, V, Vinh, DB, Virgen, CG, Woody, NM, Young, GD, Kakarala, K, Enepekides, DJ, Hier, MP, Davies, L & Ryan, WR 2025, 'Practice Patterns in Management of Low- to Intermediate-Grade Salivary Gland Carcinoma: A Multi-Institutional Study', Laryngoscope investigative otolaryngology, vol. 10, no. 5, e70246. https://doi.org/10.1002/lio2.70246

@article{0e2e05c209ab43ed9b122a7054f26e84,

title = "Practice Patterns in Management of Low- to Intermediate-Grade Salivary Gland Carcinoma: A Multi-Institutional Study",

abstract = "Objectives: To characterize practice patterns and outcomes in the management of low- and intermediate-grade salivary gland carcinoma prior to the existence of treatment guidelines. Methods: Analysis of a registry of patients who underwent parotid and submandibular gland resections for low-and intermediate-grade carcinomas between 2010 and 2019. Results: Of all 786 patients included in the study, 726 (92\%) had preoperative imaging and 653 (83\%) had preoperative biopsy. Of the 729 patients with parotid gland cancer, the majority underwent superficial (n = 384, 53\%) or total (n = 254, 35\%) parotidectomy. In patients with facial nerve preservation, total parotidectomy was associated with a significant increase in transient facial weakness (72/177 (41\%) vs. 82/311 (26\%), RR 0.65, 95\% CI 0.50–0.84, p < 0.05) and permanent facial nerve weakness (23/176 (13\%) vs. 16/301 (5\%), RR 0.41, 95\% CI 0.22–0.75, p < 0.05) compared to superficial parotidectomy. Adjuvant radiation therapy (RT) was delivered to 285 (36\%) patients. The proportion of patients receiving adjuvant RT declined significantly over the time period from 2015 to 2019 compared to 2010 to 2014 at 162/504 (32\%) and 123/282 (44\%), respectively (RR 0.74, 95\% CI 0.61–0.89, p < 0.05). When comparing the time periods from 2015 to 2019 and 2010 to 2014, there was no significant difference in local control rates (RR 0.52, 95\% CI 0.26–1.04, p = 0.06) or regional control rates (RR 0.75, 95\% CI 0.26–2.13, p = 0.58). Conclusions: Management of low- and intermediate-grade salivary cancer from 2010 to 2019 was variable, which is expected given the rarity and heterogeneity of the disease and the lack of treatment guidelines prior to 2021. Most patients with parotid malignancies underwent superficial or total parotidectomy. The extent of parotidectomy had an impact on facial nerve function outcomes. Delivery of adjuvant radiation trended down with time. The data presented here will support dissemination of the guidelines and provide data that could inform future trials. Level of Evidence: 2b.",

keywords = "facial nerve outcomes, guidelines, guidelines dissemination, major salivary gland cancer, practice patterns",

author = "Mirabelle Sajisevi and Kenny Nguyen and Peter Callas and Holcomb, \{Andrew J.\} and Emre Vural and Davis, \{Kyle P.\} and Thomas, \{Carissa M.\} and Stein, \{John S.\} and Ameya Asarkar and Ricardo Aulet and Bell, \{Rebecca K.\} and Blasco, \{Michael A.\} and Bowmaster, \{Vanessa B.\} and Burruss, \{Clayton P.\} and Jeffson Chung and Kimberly Chan and Chang, \{Brent A.\} and Coffey, \{Charles S.\} and Cognetti, \{David M.\} and Cooper, \{Dylan J.\} and Joehassin Cordero and John Donovan and Du, \{Yue Jennifer\} and Yusuf Dundar and Rogerio Dedivitis and Heather Edwards and Erovic, \{Boban M.\} and Antoine Eskander and Feinberg, \{Philip A.\} and Garvey, \{Emily A.\} and David Goldstein and Goodman, \{Joseph F.\} and Goulart, \{Rafael N.\} and Neerav Goyal and Stefan Grasl and Jonathan Giurintano and Nikita Gupta and Andy Habib and Trevor Hackman and Hara, \{Jared H.\} and Christina Henson and Hinni, \{Michael L.\} and Nadia Hua and Stephanie Johnson-Obaseki and Aditya Juloori and Kalman, \{Noah S.\} and Alexandra Kejner and Khaja, \{Sobia F.\} and Ku, \{Jamie A.\} and Arnaud Lambert and Luu, \{Bao K.\} and Magliocca, \{Kelly R.\} and \{Medina dos Santos\}, \{Luiz R.\} and Cara Michael and Brett Miles and \{de Melo\}, \{Giulianno Molina\} and Moore, \{Michael G.\} and Morand, \{Gregoire B.\} and Kau{\^e} Moura and Hesameddin Noroozi and Rusha Patel and Joseph Paydarfar and Plonowska-Hirschfeld, \{Karolina A.\} and Nader Sadeghi and Fabrice Savaria and Schmitt, \{Nicole C.\} and Justin Shapiro and Shaver, \{Timothy B.\} and Stoeckli, \{Sandro J.\} and Stokes, \{William Alvo\} and Anita Sulibhavi and Jason Tasoulas and Varun Vendra and Vinh, \{Daniel B.\} and Virgen, \{Celina G.\} and Woody, \{Neil M.\} and Young, \{Geoffrey D.\} and Kiran Kakarala and Enepekides, \{Danny J.\} and Hier, \{Michael P.\} and Louise Davies and Ryan, \{William R.\}",

note = "Publisher Copyright: {\textcopyright} 2025 The Author(s). Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.",

year = "2025",

month = oct,

doi = "10.1002/lio2.70246",

language = "English (US)",

volume = "10",

journal = "Laryngoscope investigative otolaryngology",

issn = "2378-8039",

publisher = "John Wiley and Sons Inc.",

number = "5",

}

TY - JOUR

T1 - Practice Patterns in Management of Low- to Intermediate-Grade Salivary Gland Carcinoma

T2 - A Multi-Institutional Study

AU - Sajisevi, Mirabelle

AU - Nguyen, Kenny

AU - Callas, Peter

AU - Holcomb, Andrew J.

AU - Vural, Emre

AU - Davis, Kyle P.

AU - Thomas, Carissa M.

AU - Stein, John S.

AU - Asarkar, Ameya

AU - Aulet, Ricardo

AU - Bell, Rebecca K.

AU - Blasco, Michael A.

AU - Bowmaster, Vanessa B.

AU - Burruss, Clayton P.

AU - Chung, Jeffson

AU - Chan, Kimberly

AU - Chang, Brent A.

AU - Coffey, Charles S.

AU - Cognetti, David M.

AU - Cooper, Dylan J.

AU - Cordero, Joehassin

AU - Donovan, John

AU - Du, Yue Jennifer

AU - Dundar, Yusuf

AU - Dedivitis, Rogerio

AU - Edwards, Heather

AU - Erovic, Boban M.

AU - Eskander, Antoine

AU - Feinberg, Philip A.

AU - Garvey, Emily A.

AU - Goldstein, David

AU - Goodman, Joseph F.

AU - Goulart, Rafael N.

AU - Goyal, Neerav

AU - Grasl, Stefan

AU - Giurintano, Jonathan

AU - Gupta, Nikita

AU - Habib, Andy

AU - Hackman, Trevor

AU - Hara, Jared H.

AU - Henson, Christina

AU - Hinni, Michael L.

AU - Hua, Nadia

AU - Johnson-Obaseki, Stephanie

AU - Juloori, Aditya

AU - Kalman, Noah S.

AU - Kejner, Alexandra

AU - Khaja, Sobia F.

AU - Ku, Jamie A.

AU - Lambert, Arnaud

AU - Luu, Bao K.

AU - Magliocca, Kelly R.

AU - Medina dos Santos, Luiz R.

AU - Michael, Cara

AU - Miles, Brett

AU - de Melo, Giulianno Molina

AU - Moore, Michael G.

AU - Morand, Gregoire B.

AU - Moura, Kauê

AU - Noroozi, Hesameddin

AU - Patel, Rusha

AU - Paydarfar, Joseph

AU - Plonowska-Hirschfeld, Karolina A.

AU - Sadeghi, Nader

AU - Savaria, Fabrice

AU - Schmitt, Nicole C.

AU - Shapiro, Justin

AU - Shaver, Timothy B.

AU - Stoeckli, Sandro J.

AU - Stokes, William Alvo

AU - Sulibhavi, Anita

AU - Tasoulas, Jason

AU - Vendra, Varun

AU - Vinh, Daniel B.

AU - Virgen, Celina G.

AU - Woody, Neil M.

AU - Young, Geoffrey D.

AU - Kakarala, Kiran

AU - Enepekides, Danny J.

AU - Hier, Michael P.

AU - Davies, Louise

AU - Ryan, William R.

PY - 2025/10

Y1 - 2025/10

N2 - Objectives: To characterize practice patterns and outcomes in the management of low- and intermediate-grade salivary gland carcinoma prior to the existence of treatment guidelines. Methods: Analysis of a registry of patients who underwent parotid and submandibular gland resections for low-and intermediate-grade carcinomas between 2010 and 2019. Results: Of all 786 patients included in the study, 726 (92%) had preoperative imaging and 653 (83%) had preoperative biopsy. Of the 729 patients with parotid gland cancer, the majority underwent superficial (n = 384, 53%) or total (n = 254, 35%) parotidectomy. In patients with facial nerve preservation, total parotidectomy was associated with a significant increase in transient facial weakness (72/177 (41%) vs. 82/311 (26%), RR 0.65, 95% CI 0.50–0.84, p < 0.05) and permanent facial nerve weakness (23/176 (13%) vs. 16/301 (5%), RR 0.41, 95% CI 0.22–0.75, p < 0.05) compared to superficial parotidectomy. Adjuvant radiation therapy (RT) was delivered to 285 (36%) patients. The proportion of patients receiving adjuvant RT declined significantly over the time period from 2015 to 2019 compared to 2010 to 2014 at 162/504 (32%) and 123/282 (44%), respectively (RR 0.74, 95% CI 0.61–0.89, p < 0.05). When comparing the time periods from 2015 to 2019 and 2010 to 2014, there was no significant difference in local control rates (RR 0.52, 95% CI 0.26–1.04, p = 0.06) or regional control rates (RR 0.75, 95% CI 0.26–2.13, p = 0.58). Conclusions: Management of low- and intermediate-grade salivary cancer from 2010 to 2019 was variable, which is expected given the rarity and heterogeneity of the disease and the lack of treatment guidelines prior to 2021. Most patients with parotid malignancies underwent superficial or total parotidectomy. The extent of parotidectomy had an impact on facial nerve function outcomes. Delivery of adjuvant radiation trended down with time. The data presented here will support dissemination of the guidelines and provide data that could inform future trials. Level of Evidence: 2b.

AB - Objectives: To characterize practice patterns and outcomes in the management of low- and intermediate-grade salivary gland carcinoma prior to the existence of treatment guidelines. Methods: Analysis of a registry of patients who underwent parotid and submandibular gland resections for low-and intermediate-grade carcinomas between 2010 and 2019. Results: Of all 786 patients included in the study, 726 (92%) had preoperative imaging and 653 (83%) had preoperative biopsy. Of the 729 patients with parotid gland cancer, the majority underwent superficial (n = 384, 53%) or total (n = 254, 35%) parotidectomy. In patients with facial nerve preservation, total parotidectomy was associated with a significant increase in transient facial weakness (72/177 (41%) vs. 82/311 (26%), RR 0.65, 95% CI 0.50–0.84, p < 0.05) and permanent facial nerve weakness (23/176 (13%) vs. 16/301 (5%), RR 0.41, 95% CI 0.22–0.75, p < 0.05) compared to superficial parotidectomy. Adjuvant radiation therapy (RT) was delivered to 285 (36%) patients. The proportion of patients receiving adjuvant RT declined significantly over the time period from 2015 to 2019 compared to 2010 to 2014 at 162/504 (32%) and 123/282 (44%), respectively (RR 0.74, 95% CI 0.61–0.89, p < 0.05). When comparing the time periods from 2015 to 2019 and 2010 to 2014, there was no significant difference in local control rates (RR 0.52, 95% CI 0.26–1.04, p = 0.06) or regional control rates (RR 0.75, 95% CI 0.26–2.13, p = 0.58). Conclusions: Management of low- and intermediate-grade salivary cancer from 2010 to 2019 was variable, which is expected given the rarity and heterogeneity of the disease and the lack of treatment guidelines prior to 2021. Most patients with parotid malignancies underwent superficial or total parotidectomy. The extent of parotidectomy had an impact on facial nerve function outcomes. Delivery of adjuvant radiation trended down with time. The data presented here will support dissemination of the guidelines and provide data that could inform future trials. Level of Evidence: 2b.

KW - facial nerve outcomes

KW - guidelines

KW - guidelines dissemination

KW - major salivary gland cancer

KW - practice patterns

UR - https://www.scopus.com/pages/publications/105017013650

UR - https://www.scopus.com/pages/publications/105017013650#tab=citedBy

U2 - 10.1002/lio2.70246

DO - 10.1002/lio2.70246

M3 - Article

C2 - 40995062

AN - SCOPUS:105017013650

SN - 2378-8039

VL - 10

JO - Laryngoscope investigative otolaryngology

JF - Laryngoscope investigative otolaryngology

IS - 5

M1 - e70246

ER -

Practice Patterns in Management of Low- to Intermediate-Grade Salivary Gland Carcinoma: A Multi-Institutional Study

Abstract

Bibliographical note

Keywords

UN SDGs

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