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Head and Neck Surgery

(044) Appraisal of Clinical Practice Guidelines for Salivary Gland Cancer Management

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
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    Presenting Author(s)

  • Jonathan Philip Kuriakose, MD, MS

    Resident Physician
    Northwestern Medicine
    Chicago, Illinois, United States

    • Co-Author(s)

  • Najm Khan, MBS

    Medical Student
    Rutgers - Robert Wood Johnson Medical School
    Piscataway, New Jersey, United States

  • Young Lee, MS

    Medical Student
    Central Michigan University College of Medicine
    Ann Arbor, Michigan, United States

  • KC

    Kaiwen Chen, BS

    Medical Student
    Rutgers - Robert Wood Johnson Medical School, USA

    • Senior Author(s)

  • Karthik Rajasekaran, MD

    Assistant Professor, Head and Neck Oncologic & Reconstructive Surgeon, Director of QI
    Department of Otorhinolaryngology – Head & Neck Surgery, University of Pennsylvania
    Philadelphia, Pennsylvania, United States

Disclosure(s):
Jonathan Philip Kuriakose, MD, MS: No relevant relationships to disclose.
Najm Khan, MBS: No relevant relationships to disclose.
Young Lee, MS: No relevant relationships to disclose.
Karthik Rajasekaran, MD: No relevant relationships to disclose.


Introduction: Salivary gland cancers (SGC) are rare neoplasms which comprise 1-5% of all head and neck cancers. SGCs can be managed by resection, radiosurgery, chemotherapy, or a combination of these. Our team appraised the quality of clinical practice guidelines (CPGs) for SGC treatment and management using the Appraisal of Guidelines for Research and Evaluation (AGREE-II) instrument.

Methods: Pubmed, Scopus, & EMBASE were reviewed for CPGs regarding SGC management from database inception to December 1, 2022. The AGREE-II instrument was used by four reviewers to independently evaluate guidelines. Domain scores were generated with a satisfactory threshold being >60% - a “high” quality CPG requires >4 satisfactory domains. Intraclass correlation coefficients (ICCs) were used, via R 4.2.1., to determine inter-reviewer variability.

Results: Literature review identified 645 articles, with six being included after applying inclusion and exclusion criteria. Of the six included articles, one CPG was “high” quality and five were “low” quality. The domains with the highest scores were “Editorial Independence” (72.57±36.60) and “Clarity and Presentation” (63.19±26.08), while the lowest were “Rigor of Development” (34.03±30.63) and “Applicability” (30.21±30.46). ICC scores for each domain ranged from 0.937-0.983, indicating a high level of inter-rater agreement.

Conclusions: This study found that most CPGs for the treatment and management of SGC were of “low” quality, with only one guideline being considered “high” quality based on the standard set by the AGREE-II instrument. These findings indicate that there is a high level of variability and little standardization when it comes to treatment and management of SGCs. Future CPGs should focus on improving their applicability, rigor of development, and stakeholder involvement.