Salivary Gland Tumors: Limitations of International Guidelines and Status of the planned AWMF-S3-Guideline

Abstract

Primary salivary gland carcinomas are not among the common head and neck tumors. They are characterized by manifold different histological types. Clinically, malignant tumors often cannot be distinguished from benign tumors, so that in these cases malignancy is only established by histopathological diagnosis. These are all reasons why there are relatively few clinical trials on the diagnosis, therapy and follow-up of these tumors. This in turn has the consequence that often only recommendations with limited evidence can be made in clinical guidelines. The most important international guidelines are the National Comprehensive Cancer Network (NCCN) guideline of 2023, the American Society of Clinical Oncology (ASCO) guideline of 2021, the European Society for Medical Oncology (ESMO) guideline of 2022 and still the British National Multidisciplinary guideline of 2016. These 4 international guidelines with their strengths and limitations are presented and commented here. Against this background, the development of a first German S3 clinical guideline on salivary gland tumors is important and expected to be completed in 2023. For the first time in the German guideline program on oncology, benign and malignant tumors are presented together in order to comprehensively do justice to the special features of salivary gland tumors.