title: Cervical metastases from maxillary squamous cell carcinoma: retrospective analysis and review of the literature.
abstract: The purpose of this study was to define the incidence of cervical metastasis in squamous cell carcinoma (SCC) of the maxillary alveolus, hard palate and gingiva; to identify patterns of locoregional failure and to assess survival outcomes. We retrospectively analysed 30 patients treated for SCC of the maxillary alveolus and hard palate between 2000 and 2010. Parameters assessed included the incidence of cervical metastasis at presentation and recurrence, paying particular attention to tumour staging and survival outcomes. Of our 30 patients, 25 were confirmed to have T4 SCC of the maxillary alveolus and hard palate with bone invasion. Cervical metastases had been noted in 7 (23%) patients at initial presentation. A total of 9 (36%) patients developed regional failure in the pT4 SCC group shortly after primary resection. Patients with advanced primary SCC of the hard palate and maxillary alveolus (particularly when there was bone invasion) showed high rates of regional failure, and in most cases successful salvage was not achieved. Based on our findings and a review of the existing literature we strongly recommend elective neck dissection for patients with pT4 SCC of the maxillary alveolus and hard palate.
authors.affiliation: Oral & Maxillofacial Surgery, Royal Devon & Exeter NHSFT, Barrack Road, Exeter EX2 5DW, United Kingdom. Electronic address: ayesha.dalal@nhs.net.
authors.forename: Ayesha J
authors.initials: AJ
authors.lastname: Dalal
authors.forename: Andrew S
authors.initials: AS
authors.lastname: McLennan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000539:Alveolar Process / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005887:Gingival Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008441:Maxillary Neoplasms / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D037981:Neck Dissection; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D010157:Palatal Neoplasms / Q000473:pathology / Q000601:surgery; D021362:Palate, Hard / Q000473:pathology / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Alveolus; Cervical; Gingiva; Hard palate; Maxillary; Metastasis; Neck; Regional failure; Squamous cell carcinoma