BACKGROUND: The true involvement of the submandibular gland in primary oral cancer seems quite uncommon. METHODS: We retrospectively reviewed the pathologic records of 342 patients with oral squamous cell carcinoma who underwent wide excision of primary oral cancer and simultaneous neck dissection from January 2000 to December 2003. RESULTS: Of the 383 submandibular glands, only 7 (1.8%) exhibited tumor involvement. Of them, 5 glands were involved by direct extension from the primary tumor. One gland showed local invasion from an adjacent involved lymph node in level I and 1 was from intraglandular lymph node metastasis. All of these 6 tumors with submandibular gland involvement were T4 disease (p = .0003) and the neck nodal status on each was more than N2b (p < .0001). CONCLUSION: The patients with early-stage oral squamous cell carcinoma with preoperative N 0 neck may be candidates for preservation of the submandibular gland.
