Table 1.

Thirty questions were created according to ASCO 2021 guidelines [60]

1. Is there over 30 distinct salivary gland tumor types in the latest WHO classification system, including benign and malignant ones?

2. Do the symptoms of SGC depend on the tumor location?

3. Should symptoms like pain in the face or mouth, an externally or submucosally growing lump, or facial nerve paralysis prompt consideration of SGC?

4. Is cytology or histology mandatory for diagnosing SGC?

5. Should open biopsies be avoided in major salivary gland lesions due to the risk of complicating surgical treatment and spillage, except for skin ulcerating tumors?

6. Is FDG-MRI recommended in high-grade SGC for detecting distant metastases?

7. Should IHC and molecular testing be used as primary tools for diagnosing salivary duct carcinoma and adenocarcinoma NOS with distant metastases?

8. Is analysis for NTRK fusion with NGS or whole genome sequencing mandatory for the differential diagnosis of secretory carcinoma and AcCC?

9. Should FNA be used for screening, and if inadequate, can core needle biopsy be the next step?

10. Should clinical classification be carried out after treatment, and pTNM be done before surgical resection using the UICC eighth edition staging classification?

11. Should the pathological report for the correct management of major SGC unfollow the International Collaboration on Cancer Reporting guidelines?

12. Should intraoperative frozen sections be indicated to evaluate margins of resection, perineural invasion, and lymph nodes only if the result is expected to alter management at the time of surgery?

13. Are SGCs a common and complicated subgroup of head and neck cancers?

14. Is the treatment of parotid gland cancer based on complete surgical excision with free margins?

15. Is it important to collect as much information as possible about the tumor before surgery, discuss scenarios with the patient, and be able to do a graft during the ablative procedure?

16. Should total parotidectomy always be the reference procedure for all parotid gland cancers, regardless of tumor grade?

17. Should the facial nerve be kept intact if it is not affected or surrounded by the tumor?

18. Does a preoperatively paralysed nerve VII require resection and primary reconstruction and/or reanimation procedures?

19. Should malignant tumors confined within the submandibular gland require at least resection of the gland and but not require resection of the surrounding level Ib lymph nodes?

20. Is a selective neck dissection involving levels I, II, and III contraindicated in case of high-grade malignancy without clinical evidence of cervical lymph node involvement, including the gland? No

21. Should patients with positive lymph nodes (clinical or radiological) undergo a comprehensive lymph node dissection involving levels I-V?

22. Should END be carried out when the neck is entered as an approach to the primary or for reconstruction in minor SGC?

23. Is postoperative local RT not recommended for T3-T4 and intermediate/high-grade tumors, as well as in cases with close resection margins (1–5 mm), incomplete resection margins, or perineural growth?

24. Is there proof of a beneficial effect of adding ChT to post-operative RT of the primary tumor and neck?

25. Should sequencing (NGS) of the tumor be considered in cases of recurrent/metastatic (R/M) disease?

26. Should follow-up include the use of MRI for locoregional recurrence and chest CT for lung metastases?

27. What are the most commonly used imaging techniques to assess lesions in the major salivary glands, and why is MRI considered the preferred modality?

28. Why is it important for the pathological report of major SGC to follow the International Collaboration on Cancer Reporting guidelines, and what key information should be included in the report?

29. What is the best imaging tool for locoregional recurrent disease?

30. What is the recommended duration of follow-up for patients with AdCC, and how does the frequency of imaging change over time?