J Korean Assoc Oral Maxillofac Surg.  2017 Jun;43(3):166-170. 10.5125/jkaoms.2017.43.3.166.

Is elective neck dissection needed in squamous cell carcinoma of maxilla?

• Park JH
• Nam W
• Kim HJ
• Cha IH

• KMID: 2386361
• DOI: http://doi.org/10.5125/jkaoms.2017.43.3.166

Abstract

OBJECTIVES
To define the risk of occult cervical metastasis of maxillary squamous cell carcinoma (SCC) and the therapeutic value of elective neck dissection (END) in survival of clinically negative neck node (cN0) patients.
MATERIALS AND METHODS
Sixty-seven patients with maxillary SCC and cN0 neck were analyzed retrospectively, including 35 patients with maxillary gingiva and 32 patients with maxillary sinus.
RESULTS
Of 67 patients, 10 patients (14.9%) had occult cervical metastasis. The incidence of occult cervical metastasis of maxillary gingival SCC was higher than that of maxillary sinus SCC (17.1% and 12.5%, respectively). The 5-year overall survival rate was 51.9% for the END group and 74.0% for the non-END group. The success rate of treatment for regional recurrence was high at 71.4%, whereas that for local or locoregional recurrence was low (33.3% and 0%, respectively).
CONCLUSION
The incidence of occult cervical metastasis of maxillary SCC was not high enough to recommend END. For survival of cN0 patients, local control of the primary tumor is more important than modality of neck management. Observation of cN0 neck is recommended when early detection of regional recurrence is possible irrespective of the site or T stage. The key enabler of early detection is patient education with periodic follow-up.

Keyword

Occult cervical metastasis; Squamous cell carcinoma; Maxillary gingiva; Maxillary sinus; Elective neck dissection

MeSH Terms

Carcinoma, Squamous Cell*
Epithelial Cells*
Follow-Up Studies
Gingiva
Humans
Incidence
Maxilla*
Maxillary Sinus
Neck Dissection*
Neck*
Neoplasm Metastasis
Patient Education as Topic
Recurrence
Retrospective Studies
Survival Rate

Figure

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  Fig. 1 Kaplan-Meier survival curves of overall survival for non-END group versus END group. (END: elective neck dissection)

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