Basic and patient-oriented researchOral Maxillary Squamous Cell Carcinoma: Management of the Clinically Negative Neck
Section snippets
Patients and Methods
A retrospective chart review of patients treated at the Oral and Maxillofacial Surgery Service, University of California San Francisco (UCSF) identified all patients treated for maxillary oral malignancies between 2003 and 2007. All of these patients received a complete clinical head and neck examination, as well as either magnetic resonance imaging or computed tomography scanning of the primary tumor site and neck. Radiographic findings were reviewed by both the treating surgeon and an
Results
Table 1 presents data on disease location, staging, primary neck management, and recurrence patterns for the series of patients treated at UCSF’s Oral and Maxillofacial Oncology Service. The study group comprised 5 men and 9 women ranging in age from 53 to 90 years. Postsurgical follow-up ranged from 7 to 45 months (mean, 16.58 ± 4.23 months). The mean postsurgical follow up for the N0 patients in the UCSF series was 26.43 ± 5.40 months. At presentation, 20% of the patients with maxillary
Discussion
We have shown that in our series of patients, maxillary squamous cell carcinoma involving the palate, gingival, and alveolus demonstrates a high rate of occult cervical metastasis as well as regional failure. A review of the current literature combined with our findings show that at initial presentation, maxillary palatal, gingival, and alveolar squamous cell carcinomas manifest clinically detectable cervical metastasis at rates ranging from 11.5% to 28.5% (Table 2).19, 20, 21 In addition, in
References (31)
- et al.
Current surgical treatment of squamous cell carcinoma of the head and neck
Oral Oncol
(2007) - et al.
Reappraisal of metastatic lymph node topography in head and neck squamous cell carcinomas
Otolaryngol Head Neck Surg
(2006) Histological distribution of cervical lymph node metastases from intraoral/oropharyngeal squamous cell carcinomas
Br J Oral Maxillofac Surg
(1999)- et al.
Management of the neck in patients with T1 and T2 cancer in the mouth
Br J Oral Maxillofac Surg
(2004) - et al.
Supraomohyoid neck dissection in the treatment of T1/T2 squamous cell carcinoma of the oral cavity
Am J Surg
(1994) - et al.
En bloc resection of the primary tumour and cervical lymph nodes through the parapharyngeal space in patients with squamous cell carcinoma of the maxilla: A preliminary study
Br J Oral Maxillofac Surg
(2005) - et al.
Metastasis of maxillary carcinoma to the parapharyngeal space: Rationale and technique for concomitant en bloc parapharyngeal dissection
J Oral Maxillofac Surg
(2002) - et al.
Carcinoma of the hard palate treated with radiotherapy: A retrospective review of 31 cases
Oral Oncol
(2001) - et al.
Clinicopathological analysis of elective neck dissection for N0 neck of early oral tongue carcinoma
Am J Surg
(1999) - et al.
Elective neck dissection for carcinomas of the oral cavity: Occult metastases, neck recurrences, and adjuvant treatment of pathologically positive necks
Am J Surg
(2006)
A histopathological appraisal of surgical margins in oral and oropharyngeal cancer resection specimens
Oral Oncol
Molecular biology and clinical behavior of oral cancer
Oral Maxillofac Surg Clin North Am
Surgical salvage for local and regional recurrence in oral cancer
J Oral Maxillofac Surg
Salvage surgery as the primary treatment for recurrent oral squamous cell carcinoma
Oral Oncol
Surgical pathology of cancer of the oral cavity and oropharynx
Laryngoscope
Cited by (71)
Patterns of recurrence in patients undergoing curative treatment for maxillary alveolus squamous cell carcinoma
2023, British Journal of Oral and Maxillofacial SurgeryDiagnostic value of magnetic resonance imaging in cervical lymph node metastasis of oral squamous cell carcinoma
2022, Oral Surgery, Oral Medicine, Oral Pathology and Oral RadiologyCitation Excerpt :For DSS, the cutoff was 4.1 mm, with sensitivity of 63.5%, specificity of 62.3%, and area under the ROC curve of 0.767 (P < .001). High cervical LNM rates and poor salvage rates are associated with OSCC.12 It is essential to assess preoperative cervical lymph node status accurately and provide effective treatment as an initial therapy option.
History of dysplasia and primary site associated with recurrence in T1N0 oral squamous cell carcinoma
2021, Oral Surgery, Oral Medicine, Oral Pathology and Oral RadiologyClinical course and survival in patients with squamous cell carcinoma of the maxillary alveolus and hard palate: Results from a single-center prospective cohort
2020, Journal of Cranio-Maxillofacial Surgery