# Clinical and Prognostic Factors of Submandibular Gland Malignancies: A SEER-Based Analysis: Analysis of Submandibular Gland Tumors

## TL;DR

This study analyzes submandibular gland tumors using a large database to identify factors affecting survival and treatment outcomes.

## Contribution

The study provides new insights into clinical and prognostic factors for rare submandibular gland malignancies using a population-based database.

## Key findings

- Survival outcomes varied significantly by tumor grade, histologic subtype, and treatment.
- Surgery combined with adjuvant therapies showed lower odds of death compared to radiation or chemoradiotherapy alone.
- Mucoepidermoid and ductal neoplasms had the most favorable survival outcomes.

## Abstract

While neoplasms of the submandibular gland (SMG) are rare, there is a nearly 50% risk of malignancy and its neoplasms are associated with poorer prognoses. Due to the rarity of these tumors, clinical and prognostic information relating to these tumors is limited; we aimed to elucidate these factors using an analysis of the Surveillance, Epidemiology, and End Results (SEER) database.

A retrospective population-based analysis was performed with data regarding primary SMG malignancy from 2000 to 2019 as extracted from the SEER database. Kaplan–Meier curves and log-rank tests assessed differences in survival by tumor grade and treatment. To estimate odds of death, Royston-Parmar Proportional Odds models were used. Stratified analyses were conducted by tumor stage and histology subtype.

Data from 2875 patients were extracted. Kaplan–Meier analyses on a sample of 2809 patients showed survival differing significantly by tumor grade, histologic subtype, and treatment (p < 0.0001). Most favorable survival outcomes were amongst mucoepidermoid neoplasms, ductal and lobular neoplasms, and adenocarcinomas, and least favorable survival outcomes amongst epithelial and squamous cell neoplasms. Surgery alone and with adjuvant radiation and chemoradiotherapy both showed significantly lower odds of death for the overall sample.

Multi-variate analysis indicated significantly lower odds of death with treatments involving surgery, while no significant differences were seen for radiation and chemoradiotherapy alone, likely due to the latter patients being poor surgical candidates or with advanced metastatic disease. Optimal treatment modalities for SMG malignancies are still being determined.

The online version contains supplementary material available at 10.1007/s12105-025-01882-z.