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Summary This thesis describes clinico- and histopathological prognosticators as well as outcome in malignant salivary gland carcinomas of the head and neck with an emphasis on three predominant tumor types: Adenoid cystic carcinoma (ACC), mucoepidermoid carcinoma (MEC) and acinic cell carcinoma (AciCC). The results presented were gathered through retrospective analysis of patient data from the Amsterdam University Medical Centres (Amsterdam UMC) Vrije Universiteit Amsterdam. In the study regarding AciCC, patient data from both the Amsterdam UMC and the Netherlands Cancer Institute (NKI) were used.

Summary This thesis describes clinico- and histopathological prognosticators as well as outcome in malignant salivary gland carcinomas of the head and neck with an emphasis on three predominant tumor types: Adenoid cystic carcinoma (ACC), mucoepidermoid carcinoma (MEC) and acinic cell carcinoma (AciCC). The results presented were gathered through retrospective analysis of patient data from the Amsterdam University Medical Centres (Amsterdam UMC) Vrije Universiteit Amsterdam. In the study regarding AciCC, patient data from both the Amsterdam UMC and the Netherlands Cancer Institute (NKI) were used.

Salvage surgery (SS) in head and neck cancer is considered a last resort treatment after failure of organ preservation treatments. It offers challenges to the patients and the surgeon. The outcome of SS is often uncertain in terms of survival and quality of life. This paper offers an overview of evolution in SS, tumor and patient factors to be considered, challenges in reconstructive surgery, complications of SS and the changing landscape with regard to increasing incidence of human papillomavirus positive tumours, the role of transoral robotic surgery, the importance of multidisciplinary management and shared decision making.

Background. The purpose of this study was to evaluate active surveillance strategy in the clinically negative neck in maxillary squamous cell carcinoma (SCC). Methods. One hundred fourteen consecutive patients diagnosed with oral maxillary SCC were analyzed retrospectively from 3 centers in The Netherlands. Analysis parameters included regional disease-free survival of N0 patients stratified for T classification, elective radiotherapy (RT) of the neck; and overall survival of the whole cohort, stratified by N classification; salvage neck surgery rates. Results. Within the N0 cohort, 26.0% of the patients developed neck metastasis in the follow-up visits. Regional recurrence was not related to T classification or postoperative RT of the neck. Regional and locoregional recurrence were associated with diminished overall survival (p

Background Sentinel node biopsy (SNB) in head and neck cancer is recently introduced as the staging technique of oral squamous cell carcinoma. We report the results of SNB in patients diagnosed with a T1-T2 oral squamous cell carcinoma and clinically negative (N0) neck in a single center. Methods A retrospective analysis of 90 previously untreated patients who underwent SNB between 2007 and 2012 was performed. The SNB procedure consisted of preoperatively performed lymphoscintigraphy, intraoperative detection using blue dye, and gamma probe guidance and histopathologic examination including step-serial sectioning (SSS) and immunohistochemical (IHC) staining. A positive SNB was followed by neck dissection, whereas regular follow-up with ultrasound-guided fine-needle aspiration cytology (FNAC) was done in case of a negative SNB. Results The lymphoscintigraphic identification rate was 98% (88 of 90 patients) and the surgical detection rate was 99% (87 of 88 patients). The upstaging rate was 30%. Sensitivity of SNB was 93% and the negative predictive value was 97%. The median follow-up was 18 months (range, 2-62 months). Overall survival (OS) and disease-free survival (DFS) for SNB negative were 100% and 84% and for SNB positive patients 73% and 88%, respectively. Conclusion SNB is a reliable diagnostic staging technique for the clinically negative neck in patients with early-stage (T1-T2, cN0) oral squamous cell carcinoma.