[Malignant tumors of the salivary glands: early diagnosis, follow-up and therapy].

Problems of early recognition, postoperative care, and therapy were studied in 207 patients with malignant tumors of the salivary glands, who were treated from 1965 to 1975. Early recognition of these malignant tumors is hampered by the circumstance that only a very short time span is available for diagnosis of the highly malignant types and by the lack of knowledge about specific risk groups among the population. Important for postoperative care is the high rate of local tumor recurrence, especially of salivary-duct, mucoepidermoid, acinic-cell, and adenoid-cystic carcinomas, ranging from 71% to 83%. Late recurrence is frequent. There is also a close connection between local recurrence and lymphogenic or hematogenic formation of metastases. The therapy of choice for malignant tumors of the salivary glands is surgery and, depending on the tumor type, postoperative irradiation. Chemotherapy is at present still of minor importance. Histologic tumor type and tumor stage determine the extent of the surgical procedures, which range from lateral parotidectomy with preservation of the facial nerve to radical parotidectomy with or without reconstruction of the facial nerve. In spite of radical surgery, many malignomas of the salivary glands, particularly the adenoid-cystic carcinomas, tend to recur. In such cases the long-term prognosis is poor and cannot be improved by postoperative irradiation. Supplemented by the experience gained in postoperative care, we have summarized the guidelines along which these 207 salivary-gland malignomas were treated into a modified concept of therapy.