In the presence of bulky nodal disease in squamous cell carcinoma, US combined with FDG-PET/CT was found to be a reliable strategy to identify patients with complete nodal response to therapy, with a higher combined NPV [65]. Variant 8: Treated cancer of a major salivary gland (parotid, submandibular, and sublingual glands). Surveillance imaging or follow-up imaging for suspected or known recurrence. Physical examination and imaging surveillance following treatment of malignant neoplasms of the major salivary glands may be obscured or impeded by postoperative scarring and anatomic distortion. Furthermore, deep local recurrences and perineural tumor spread can be inaccessible to clinical assessment and may go overlooked, particularly in early stages [108]. Delayed diagnosis of tumor recurrence portends a poor prognosis and a decrease in long-term survival, independent of histologic type [108,152]. Because perineural tumor spread is common in malignant salivary gland tumors, in particular in adenoid cystic carcinoma, a complete radical resection may not always be feasible and postoperative radiotherapy may be indicated [152]. Regular follow-up is recommended following treatment of malignant salivary gland neoplasms [152]. The majority, approximately 70%, of recurrences of high-grade malignant salivary gland tumors occur in the first 3 years Assessment of Head and Neck Cancer following treatment [108], and these can be subclassified into local, regional, and distant. In a large cohort of 565 patients with salivary gland tumors followed over a 10 year period, local recurrence was reported in 13% of the cases, regional recurrence was seen in 22% of the cases, and distant metastases were documented in 33% of the patients [108]. Other studies reported distant disease in >50% of patients, with adenoid cystic carcinoma, adenocarcinoma, and carcinoma ex pleomorphic adenoma accounting for the majority of the cases [108].
Staging and Post Therapy Assessment of Head and Neck Cancer. In the presence of bulky nodal disease in squamous cell carcinoma, US combined with FDG-PET/CT was found to be a reliable strategy to identify patients with complete nodal response to therapy, with a higher combined NPV [65]. Variant 8: Treated cancer of a major salivary gland (parotid, submandibular, and sublingual glands). Surveillance imaging or follow-up imaging for suspected or known recurrence. Physical examination and imaging surveillance following treatment of malignant neoplasms of the major salivary glands may be obscured or impeded by postoperative scarring and anatomic distortion. Furthermore, deep local recurrences and perineural tumor spread can be inaccessible to clinical assessment and may go overlooked, particularly in early stages [108]. Delayed diagnosis of tumor recurrence portends a poor prognosis and a decrease in long-term survival, independent of histologic type [108,152]. Because perineural tumor spread is common in malignant salivary gland tumors, in particular in adenoid cystic carcinoma, a complete radical resection may not always be feasible and postoperative radiotherapy may be indicated [152]. Regular follow-up is recommended following treatment of malignant salivary gland neoplasms [152]. The majority, approximately 70%, of recurrences of high-grade malignant salivary gland tumors occur in the first 3 years Assessment of Head and Neck Cancer following treatment [108], and these can be subclassified into local, regional, and distant. In a large cohort of 565 patients with salivary gland tumors followed over a 10 year period, local recurrence was reported in 13% of the cases, regional recurrence was seen in 22% of the cases, and distant metastases were documented in 33% of the patients [108]. Other studies reported distant disease in >50% of patients, with adenoid cystic carcinoma, adenocarcinoma, and carcinoma ex pleomorphic adenoma accounting for the majority of the cases [108].