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Oral maxillary squamous carcinoma: An indication for neck dissection in the clinically negative neck
Author(s) -
Montes David M.,
Carlson Eric R.,
Fernandes Rui,
Ghali G. E.,
Lubek Joshua,
Ord Robert,
Bell Bryan,
Dierks Eric,
Schmidt Brian L.
Publication year - 2011
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.21631
Subject(s) - medicine , neck dissection , cervical lymph nodes , surgery , dissection (medical) , squamous carcinoma , epidermoid carcinoma , retrospective cohort study , lymph node , carcinoma , radiology , metastasis , cancer
Background This multicenter study was undertaken to characterize the metastatic behavior of oral maxillary squamous carcinoma and to determine the role of selective neck dissection. Methods A retrospective, multicenter study of patients surgically treated for oral maxillary squamous carcinoma was completed. Data collected included primary tumor location, cervical lymph node status, and neck failure rate. Results The study included 146 patients. The adjusted regional metastatic rate was 31.4%. Of those N0 (clinically negative) necks treated with or without neck dissection, 14.4% developed cervical metastasis. Within the cohort, 7.5% of patients died with distant disease. The regional salvage rate was 52.9%. None of the patients with locoregional failures were salvaged. Conclusions Maxillary palatal, alveolar, and gingival squamous carcinomas exhibit aggressive regional metastatic behavior. Surgical salvage rates for neck failure are low; therefore, selective neck dissection (levels I–III) is recommended at the time of resection of T2, T3, and T4 maxillary squamous carcinomas. © 2010 Wiley Periodicals, Inc. Head Neck, 2011