Cervical metastases of squamous cell carcinoma of the maxilla: a retrospective study of 25 years.
OBJECTIVE
Squamous cell carcinomas (SCCs) of the maxilla are relatively rare; therefore, only little data is available regarding the frequency of cervical metastasis (CM) and therapy strategies. Most authors only undertake clinical observation of the lymph nodes. The aim of this retrospective study was to evaluate the manner of metastasis in SCC of the maxilla.


METHODS
All patient records from 1987 to 2011 were scanned for SCC of the maxilla. Patients with SCC limited to the maxilla were comprised. The cases were analyzed regarding tumor node metastasis staging system and any special occurrences in the follow-up time such as tumor recurrence, metastasis, and exitus letalis. Classification and staging were performed according to the 2003 UICC system.


RESULTS
One hundred thirty-eight patients were comprised of 36 % females and 64 % males (average age, 66 years; women, 71 years; men, 63 years). The average follow-up time was 43 months (range, 0-195). Fifty-eight percent smoked or declared regular consumption of alcohol. About 50 % of the patients had an advanced tumor stage (III-IV). At the time of the primary diagnosis, 38 % of the patients had CM. There is an increased risk for CM occurrence with increasing tumor size and grading and a tumor localized in the postcanine region. Contralateral CM arises frequently in T4 tumors and tumors localized in the postcanine region.


CONCLUSIONS
The data exhibit aggressive regional metastatic behavior of SCC of the maxilla.


CONCLUSIONS
Therefore, surgical treatment of the draining lymphatic system as a primary management strategy is recommended for patients with SCC of the maxilla.
Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg-University of Mainz, Augustusplatz 2, 55131, Mainz, Germany. Keyvan.sagheb@unimedizin-mainz.de.
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Sagheb
Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg-University of Mainz, Augustusplatz 2, 55131, Mainz, Germany.
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Sagheb
Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg-University of Mainz, Obere Zahlbacher Str. 69, 55131, Mainz, Germany.
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Taylor
Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg-University of Mainz, Augustusplatz 2, 55131, Mainz, Germany.
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Al-Nawas
Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg-University of Mainz, Augustusplatz 2, 55131, Mainz, Germany.
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Walter
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008441:Maxillary Neoplasms / Q000473:pathology*; D008875:Middle Aged; D009333:Neck; D012307:Risk Factors