title: Oral maxillary squamous carcinoma: an indication for neck dissection in the clinically negative neck.
abstract: 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.
authors: Department of Oral and Maxillofacial Surgery, Sanford-MeritCare Health System, Fargo, North Dakota, USA.
authors: David M
authors: DM
authors: Montes
authors: Eric R
authors: ER
authors: Carlson
authors: Rui
authors: R
authors: Fernandes
authors: G E
authors: GE
authors: Ghali
authors: Joshua
authors: J
authors: Lubek
authors: Robert
authors: R
authors: Ord
authors: Bryan
authors: B
authors: Bell
authors: Eric
authors: E
authors: Dierks
authors: Brian L
authors: BL
authors: Schmidt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008441:Maxillary Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D037981:Neck Dissection / Q000706:statistics & numerical data*; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome