Non-Cochrane · intervention · PM42376660
Submandibular gland preservation versus removal during neck dissection in oral squamous cell carcinoma: a systematic review and meta-analysis.
Shazo Sargon, Ranganathan Raji, Cirignaco Giulio, et al. · Frontiers in oncology · 2026 · PubMed · doi:10.3389/fonc.2026.1818542
Findings
Population Adult patients with primary oral squamous cell carcinoma undergoing neck dissection including level Ib
6 findings
| Submandibular gland preservation during neck dissection | Submandibular gland resection during neck dissection | Disease-specific survival Longest available follow-up · All studies | RR 0.86 [0.40, 1.82] Low Downgraded: risk of bias, imprecision 2 studies · 278 participants |
| Submandibular gland preservation during neck dissection | Submandibular gland resection during neck dissection | Locoregional recurrence Longest available follow-up · All studies | RR 1.05 [0.71, 1.55] Low Downgraded: risk of bias, imprecision, inconsistency, publication bias 7 studies · 981 participants |
| Submandibular gland preservation during neck dissection | Submandibular gland resection during neck dissection | Locoregional recurrence Longest available follow-up · Early-stage OSCC (N0) studies (Chen 2011, Markey 2018, Gu B 2020, Du 2020, Karnati 2024) | RR 0.90 [0.59, 1.40] GRADE not reported 5 studies · 764 participants |
| Submandibular gland preservation during neck dissection | Submandibular gland resection during neck dissection | Overall survival Longest available follow-up · All studies | RR 0.80 [0.38, 1.72] Low Downgraded: risk of bias, imprecision 3 studies · 703 participants |
| Submandibular gland preservation during neck dissection | Submandibular gland resection during neck dissection | Locoregional recurrence Longest available follow-up · All stages OSCC studies (Lanzer 2014, Shih 2023) | RR 3.39 [0.36, 31.58] GRADE not reported 2 studies · 217 participants |
| Submandibular gland preservation during neck dissection | Submandibular gland resection during neck dissection | Regional (neck) recurrence Longest available follow-up · All studies | RR 1.68 [0.84, 3.37] Low Downgraded: risk of bias, imprecision 3 studies · 349 participants |
Included primary studies 8
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Chen 2011 Feasibility of preservation of the submandibular gland during neck dissection in patients with early-stage oral cancer. PMID:20839068 | 2011 | this review only | not stated | not extracted yet |
| Du 2020 Feasibility of Submandibular Gland Preservation in cT1-2N0 Squamous Cell Carcinoma in the Floor of the Mouth. PMID:32373538 | 2020 | this review only | not stated | not extracted yet |
| Gu B 2020 Impact of submandibular gland preservation in neck management of early-stage buccal squamous cell carcinoma on locoregional control and… PMID:33109130 | 2020 | this review only | not stated | not extracted yet |
| Gu H 2022 Functional outcomes after submandibular gland-sparing neck dissection in patients with oral squamous cell carcinoma. PMID:34674918 | 2022 | this review only | not stated | not extracted yet |
| Karnati 2024 Efficacy of Submandibular Gland Excision Versus Preservation During Supraomohyoid Neck Dissection for T1, T2, and N0 Oral Squamous Cell… PMID:39734988 | 2024 | this review only | not stated | not extracted yet |
| Lanzer 2014 Preservation of ipsilateral submandibular gland is ill advised in cancer of the floor of the mouth or tongue. PMID:24623566 | 2014 | this review only | not stated | not extracted yet |
| Markey 2018 The effect of submandibular gland preservation during level 1B neck dissection on postoperative xerostomia. PMID:28449980 | 2018 | this review only | not stated | not extracted yet |
| Shih 2023 Gland-sparing neck dissection: oncological and functional outcomes in oral cancer patients. PMID:36517308 | 2023 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adult patients (>=18 years) with primary OSCC undergoing neck dissection including level I/Ib | Adults with OSCC undergoing neck dissection (n=1,220; 286 SMG preserved, 934 resected) |
| Intervention | Intentional SMG preservation during neck dissection | SMG preservation (n=286) |
| Comparison | SMG resection (excision) as part of neck dissection | SMG resection (n=934) |
| Outcomes | Locoregional recurrence, regional recurrence, disease-specific survival, overall survival, xerostomia severity or other validated quality-of-life measures | Locoregional recurrence (7 studies); regional recurrence (3); disease-specific survival (2); overall survival (3); xerostomia (4 studies, narrative only) |
| Study designs | RCTs and non-randomized comparative studies | 8 observational cohort studies (6 retrospective, 2 prospective) |
| Timing | Not specified | Follow-up 6 to 56.7 months |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | No | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | No | No | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | NRSI: Yes · RCT: N/A | RCT: N/A · NRSI: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | NRSI: Yes · RCT: N/A | RCT: N/A · NRSI: No | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |