Oral Maxillary Squamous Cell Carcinoma: Management of the Clinically Negative Neck

Oral maxillary squamous carcinoma: An indication for neck dissection in the clinically negative neck

“…Recently, 2 groups have published their experience with maxillary squamous carcinomas. 1,2 These independent studies suggest that maxillary squamous carcinoma behaves similarly to other well-studied oral cavity subsites with respect to regional metastasis. However, both of these studies are limited by small patient numbers.…”

“…The current surgical data regarding the rate of cervical metastasis are based on the experience of 2 publications composed of only 40 patients. 1,2 There is no information regarding the highest risk location harboring occult metastasis from maxillary squamous carcinoma nor as to whether cervical lymph nodes become involved without the concomitant parapharyngeal and superficial buccal lymphatic basin metastatic spread. [3][4][5] Management of the clinically negative neck in patients with maxillary oral cavity squamous carcinoma has received little attention compared with other oral cavity subsites such as the oral tongue, floor of mouth, and mandibular gingival.…”

Cervical metastasis of maxillary squamous cell carcinoma

“…Only recently have studies focused on the cervical metastasis of maxillary SCC. [3][4][5][6][7][8][9] However, prospective and evidencebased studies are still lacking and the treatment of the clinical negative neck remains controversial.…”

Nodal involvement and p16-staining in upper alveolar ridge and hard palate cancer

“…Size of the primary tumor and histological grade was significantly associated with survival, and clinical stage was the most important prognostic indicator [30] . Recent retrospective series with 26 to 146 upper alveolar ridge and hard palate cases reported a neck lymph node involvement between 11% and 36.6%, and regional recurrence in N0 neck from 14% to 27% [1,[5][6][7][8] . These studies had several findings: cases with neck node involvement had higher grade; clinical stage but not margin status was associated with prognosis; and T3 (55%) and T4 (52%) tumors exhibited higher rates of neck lymph node involvement than smaller tumors (T1 = 15%; T2 = 28%).…”

“…Prognostic factors and neck management in head and neck SCC (HNSCC) have been extensively studied in series of tongue or floor of mouth SCC, or on series with a mixture of SCC tumor sites [2] . Only small retrospective series have evaluated the behavior of hard palate and upper alveolus, and suggest that they have a low rate of regional node metastases [3][4][5][6][7][8] . However, recent studies find higher rates of both neck lymph node involvement and neck recurrence in these malignancies, and, there is a need to identify those aggressive cases that would benefit from more aggressive treatment [9,10] .…”