Treatment of N in the upper maxillary tumors.
From 2002 to 2008, 86 patients have undergone surgical treatment of malignant upper maxillary tumors at the Maxillo-Facial Surgery Department, Tor Vergata University, Rome. All the N-positive patients at the time of the T therapy have undergone lymph node surgical emptying. In 6 patients, a laterocervical emptying was performed when laterocervical metastases were found. In the remaining 68 patients, with no evidence of N, we did not perform laterocervical emptying. We found in our patients a high percentage of cervical metastasis in T2 squamous cell carcinoma of the maxilla (32.1%). In this article, the authors present the results of their experience in treating N in upper maxillary tumors. This research study highlights some important aspects that have to be considered. Squamous cell carcinoma of the maxilla extending to the oral cavity (T1-T2) shows a higher laterocervical lymphophily than the superoposterior ones (T3-T4). Presence or appearance of lymph node metastases is a high-malignancy index, with a subsequently very negative prognosis. Considering the large percentage of cervical recurrences in T1-T2 squamous cell carcinoma of the maxilla that spread up in the hard palate mucosa and upper gum and the consequently high morbidity, performing a prophylactic laterocervical emptying in these patients could be advisable. Even in the recent literature, we found opinion in favor of this behavior.
Odontostomatology Department, Maxillo-Facial Surgery, Università di Tor Vergata, Rome, Italy.
Gianluca
G
Nicolai
Bruno
B
Lorè
Gianmarco
G
Prucher
Leonardo
L
De Marinis
Leonardo
L
Calabrese
D000230:Adenocarcinoma / Q000556:secondary / Q000601:surgery; D002277:Carcinoma / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D003528:Carcinoma, Adenoid Cystic / Q000556:secondary / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000556:secondary / Q000601:surgery; D018572:Disease-Free Survival; D005887:Gingival Neoplasms / Q000473:pathology; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D008441:Maxillary Neoplasms / Q000473:pathology / Q000601:surgery*; D037981:Neck Dissection / Q000379:methods*; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D010157:Palatal Neoplasms / Q000473:pathology; D015996:Survival Rate