Oral squamous cell carcinoma involving the maxillae: Factors affecting local recurrence and the value of salvage treatment for overall survival

Head Neck. 2020 Aug;42(8):1821-1828. doi: 10.1002/hed.26108. Epub 2020 Feb 26.

Abstract

Objective: To determine factors associated with local recurrence (LR) of oral squamous cell carcinoma involving the maxillae (MSCC) and overall survival (OS) after salvage treatment.

Subjects and methods: Retrospective study of MSCC operated between 2000 and 2015. Kaplan-Meier survival and Cox regression were used for analysis of MSCC-associated clinical and histopathological factors.

Results: Ninety-five patients were included. LR occurred in 24% of patients. Vascular invasion significantly increased the risk of LR (hazard ratio 4.595, P = .003). Local salvage surgery, in the area of the original tumor, significantly prolonged OS, compared to palliative treatment (P = .001) and extensive salvage surgery (P = .013). Extensive salvage surgery, requiring resection of adjacent facial structures, did not prolong OS compared to palliative treatment (P = .186).

Conclusions: MSCC with vascular invasion has higher risk of LR. Salvage surgery may prolong OS in small recurrences but might have dubious value for larger recurrences infiltrating adjacent facial structures.

Keywords: 5-year local control; malignancy; maxillary cancer; maxillectomy; salvage treatment; squamous cell carcinoma.

MeSH terms

  • Carcinoma, Squamous Cell* / surgery
  • Head and Neck Neoplasms*
  • Humans
  • Maxilla
  • Mouth Neoplasms* / surgery
  • Neoplasm Recurrence, Local
  • Prognosis
  • Retrospective Studies
  • Salvage Therapy
  • Squamous Cell Carcinoma of Head and Neck
  • Treatment Outcome