title: Survival impact of nodal disease in hard palate and maxillary alveolus cancer.
abstract: OBJECTIVE
  Evaluate the impact of primary site stage and cervical metastasis on the survival of patients with squamous cell carcinoma (SCC) of the hard palate or maxillary alveolus.
  
  
  METHODS
  Cross-sectional population analysis of prospectively maintained database.
  
  
  METHODS
  Cases of hard palate and maxillary alveolus SCC from 1988-2004 were extracted from the Surveillance, Epidemiology, and End Results database. Demographic data and extent of disease were extracted for each case, and T-stage, and N-stage were computed. Survival differences according to T-stage and N-stage were determined with the Kaplan-Meier method and the log-rank test.
  
  
  RESULTS
  Four hundred eleven cases of maxillary alveolus and 314 cases of hard palate SCC were identified, for a total of 725 cases (53.9% female, mean age: 70.9 years). The prevalence of cervical metastasis was not significantly different according to primary site (P = .181); advanced N-stage significantly correlated with more advanced T-stage (P < .001). Of the 725 cases, 4.1% of T1 tumors, 14.9% of T2 tumors, 10.3% of T3 tumors, and 24.7% of T4 tumors had cervical nodal metastases. The mean overall survivals were 96.5, 69.1, 67.8, and 49.3 months for T1-T4 tumors, respectively (P < .001). With regard to N-stage, the mean survivals were 73.7, 69.7, 29.8, and 5.5 months for N0-N3 lesions, respectively (P < .001). Nodal metastasis effect on survival remained significant (P < .039) in stratified survival analysis except for T3 lesions (P = .205).
  
  
  CONCLUSIONS
  Survival in patients with SCC of either the hard palate or maxillary alveolus is significantly influenced by T-stage and a nonnegligible rate of cervical nodal metastases.
authors.affiliation: Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
authors.forename: Harrison W
authors.initials: HW
authors.lastname: Lin
authors.forename: Neil
authors.initials: N
authors.lastname: Bhattacharyya
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008437:Maxilla / Q000473:pathology*; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D010157:Palatal Neoplasms / Q000401:mortality* / Q000473:pathology*; D021362:Palate, Hard / Q000473:pathology*; D015995:Prevalence; D011446:Prospective Studies; D018426:SEER Program; D016019:Survival Analysis