title: Lymph node metastasis in t4 maxillary sinus squamous cell carcinoma: incidence and treatment outcome.
abstract: BACKGROUND
  The purpose of this study was to evaluate the incidence of lymph node metastasis among patients with T4 maxillary sinus squamous cell carcinoma (MS-SCC) as well as the delayed metastasis rate and the treatment outcome for untreated N0 neck in patients with T4 MS-SCC.
  
  
  METHODS
  Consecutive series of all patients (n = 128) with previously untreated T4 maxillary sinus SCC between 2006 and 2007 were obtained from 28 institutions belonging to or cooperating in the Head and Neck Cancer Study Group of the Japan Clinical Oncology Group.
  
  
  RESULTS
  Of the 128 patients, 28 (21.9 %) had lymph node metastasis, and six patients (4.7 %) had distant metastasis at diagnosis. Among the 111 patients who were treated with curative intent, 98 had clinically N0 neck disease and did not receive prophylactic neck irradiation. A total of 11 patients (11.2 %) subsequently developed evidence of lymph node metastasis, of whom eight were among the 83 patients with an N0 neck and had not received elective neck treatment. There were 15 patients who received an elective neck dissection as part of the initial treatment, of whom three had pathologically positive for lymph node metastases. Of 11 patients, six patients with nonlateral retropharyngeal lymph node metastasis without primary or distant disease were successfully salvaged.
  
  
  CONCLUSIONS
  This study identified the incidence of lymph node metastasis among patients with T4 MS-SCC as well as the delayed metastasis rate and the treatment outcome for untreated N0 neck in patients with T4 MS-SCC. These results will be of assistance in selecting treatment strategy for T4 MS-SCC in the future.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan, ak-homma@med.hokudai.ac.jp.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Homma
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Hayashi
authors.forename: Kazuto
authors.initials: K
authors.lastname: Matsuura
authors.forename: Kengo
authors.initials: K
authors.lastname: Kato
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kawabata
authors.forename: Nobuya
authors.initials: N
authors.lastname: Monden
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Onitsuka
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Fujimoto
authors.forename: Shigemichi
authors.initials: S
authors.lastname: Iwae
authors.forename: Kenji
authors.initials: K
authors.lastname: Okami
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsuzuka
authors.forename: Kunitoshi
authors.initials: K
authors.lastname: Yoshino
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Nibu
authors.forename: Takakuni
authors.initials: T
authors.lastname: Kato
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nishino
authors.forename: Takahiro
authors.initials: T
authors.lastname: Asakage
authors.forename: Ichiro
authors.initials: I
authors.lastname: Ota
authors.forename: Morimasa
authors.initials: M
authors.lastname: Kitamura
authors.forename: Akira
authors.initials: A
authors.lastname: Kubota
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Ueda
authors.forename: Kaichiro
authors.initials: K
authors.lastname: Ikebuchi
authors.forename: Akihito
authors.initials: A
authors.lastname: Watanabe
authors.forename: Masato
authors.initials: M
authors.lastname: Fujii
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000556:secondary / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008443:Maxillary Sinus / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D037981:Neck Dissection; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D010255:Paranasal Sinus Neoplasms / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies