Involvement of the Submandibular Gland inEarly Oral Cavity Squamous Cell Carcinoma

Background: Early Oral Cavity Squamous Cell Carcinoma (OCSCC) commonly metastasizes to cervical lymph nodes, whereas involvement of the Submandibular Gland (SMG) is uncommon. Evaluating the frequency of SMG metastasis is essential to inform the feasibility of SMG-sparing neck dissection, which can minimize surgical morbidity while ensuring oncologic safety. This study aimed to determine the prevalence of SMG involvement and the pattern of cervical lymph node metastasis in patients with early-stage OCSCC. Materials and methods: A cross-sectional observational study was conducted from January 2022 to June 2023 at the Departments of Otolaryngology-Head & Neck Surgery and Oral & Maxillofacial Surgery, Bangladesh Medical University, Dhaka. Forty-four patients with T1–T2, N0 OCSCC were enrolled. Tumors were excised with a 1 cm margin and elective neck dissection including ipsilateral SMG was performed. Histopathological evaluation assessed SMG involvement, lymph node status, lymphovascular invasion, perineural invasion, depth of invasion and margin status. Results: Buccal mucosa (45.5%) and tongue (38.6%) were the most common tumor sites. T1N0M0 tumors predominated in the tongue, while T2N0M0 tumors were more frequent in the buccal mucosa. SMG metastasis was observed in only one patient (2.3%) originating from the tongue, with no significant association with tumor subsite. Level I lymph node involvement was highest in buccal mucosa tumors (60%) whereas Level II involvement was highest in buccal mucosa (95%) and tongue (52.9%) with a significant association for Level II nodes (p=0.026). Lymphovascular invasion was observed in a minority of patients and was not significantly associated with tumor subsite. Mean depth of invasion was similar between T1 and T2 tumors (0.7 cm, p=0.572). Conclusion: SMG involvement in early OCSCC is exceedingly rare, supporting SMGsparing neck dissection in clinically node-negative cases. Level II lymph nodes remain at higher risk, emphasizing the need for careful nodal assessment. SMG preservation can reduce surgical morbidity without compromising oncologic safety. Chatt Maa Shi Hosp Med Coll J; Vol.25 (2); July 2026; Page 39-43