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Management of the clinically N0 neck in squamous cell carcinoma of the maxillary alveolus and hard palate
Author(s) -
Os Alejandra D. van,
Karakullukcu Baris,
Leemans C. René,
Halmos Gyorgy B.,
Roodenburg Jan L. N.,
Weert Stijn van,
Karagozoglu K. Hakki,
Witjes Max J. H.
Publication year - 2016
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.24511
Subject(s) - medicine , neck dissection , cohort , watchful waiting , radiation therapy , metastasis , surgery , head and neck cancer , hard palate , carcinoma , radiology , cancer , prostate cancer
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