Cervical metastasis of maxillary squamous cell carcinoma

Int J Oral Maxillofac Surg. 2015 Mar;44(3):285-91. doi: 10.1016/j.ijom.2014.10.020. Epub 2014 Nov 20.

Abstract

A retrospective study of maxillary squamous cell carcinoma (SCC) patients attending a department of oral and maxillofacial surgery was performed for the period 2000-2010. The clinical information of 100 cases treated during this period was acquired and analyzed. Patient survival was calculated using the Kaplan-Meier method. For these 100 cases, the total metastatic rate was 34.0% and occult metastatic rate was 27.5%. Positive lymph nodes were mostly detected at levels I-III. There was no significant difference in metastatic rate between the primary sites of maxillary gingiva and hard palate. Tumours involving the gingival-buccal sulcus presented a significantly higher risk of metastasis. Advanced stage (T3/4) was significantly correlated with a higher metastasis rate. The pathological grade also showed a significant relationship with metastasis. Twenty-four patients presented regional recurrence. Elective neck dissection could significantly reduce the recurrence rate. The overall 3-year and 5-year survival rates were 66.3% and 56.7%, respectively. Both the T and the N stages had a significant impact on survival rates. Selective neck dissection from level I to III is recommended for T3/4 stage cN0 patients, especially those with gingival-buccal sulcus involvement.

Keywords: cervical metastasis; elective neck dissection; hard palate; maxillary gingiva; squamous cell carcinoma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / secondary*
  • Carcinoma, Squamous Cell / surgery*
  • Female
  • Head and Neck Neoplasms / secondary*
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Lymphatic Metastasis
  • Male
  • Maxillary Neoplasms / pathology*
  • Maxillary Neoplasms / surgery*
  • Middle Aged
  • Neck Dissection
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome