Management of the clinically N0 neck in squamous cell carcinoma of the maxillary alveolus and hard palate

Head Neck. 2016 Dec;38(12):1794-1798. doi: 10.1002/hed.24511. Epub 2016 Jul 4.

Abstract

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 < .05). Regional metastasis was operable in 22 of 26 cases (85%). Only 1 patient presented with inoperable neck metastasis without local recurrence.

Conclusion: Watchful waiting was feasible in this cohort. If meticulous follow-up is not available, elective neck dissection is recommended. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1794-1798, 2016.

Keywords: active surveillance; maxillary cancer; neck dissection.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / therapy
  • Cohort Studies
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Humans
  • Lymph Nodes / pathology
  • Lymphatic Metastasis / pathology
  • Male
  • Maxillary Neoplasms / mortality
  • Maxillary Neoplasms / pathology*
  • Maxillary Neoplasms / therapy
  • Middle Aged
  • Neck / pathology*
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Netherlands
  • Palatal Neoplasms / mortality
  • Palatal Neoplasms / pathology*
  • Palatal Neoplasms / therapy
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Watchful Waiting / methods*