title: Are There Clinical or Pathological Parameters of Maxillary Oral Squamous Cell Carcinoma With an Influence on the Occurrence of Neck Node Metastasis? An Appraisal of 92 Patients.
abstract: OBJECTIVE
  To determine the proportion of patients with cervical metastases caused by maxillary oral squamous cell carcinoma (OSCC) and to identify any clinical or pathologic parameters that might be associated with the occurrence of metastatic neck disease.
  
  
  METHODS
  A retrospective cohort study of all patients managed with primary surgical resection of maxillary OSCC at the authors' institution from 2006 through 2013 was performed. Cervical lymph node dissection and adjuvant therapy were performed as warranted by preoperative staging examinations or histopathologic evaluation or as recommended after multidisciplinary consultation, and regular follow-up protocols were followed. In this analysis, each maxillary OSCC was assigned to an anterior or a posterior anatomic group based on the location of the primary lesion, with the anatomic tumor location serving as the predictor variable and the occurrence of cervical lymph node metastases as the outcome variable. Descriptive and inferential statistics were calculated with a significance level set at a P value less than .05 and post hoc power analyses were performed.
  
  
  RESULTS
  The study sample was composed of 92 patients (38 women, 54 men; average age, 60.9 yr). Overall, 27 patients developed cervical metastases (29.3%). Neck disease was present in 15 patients (16.3%) at initial presentation. Delayed cervical metastases were diagnosed in 12 patients (13%) and manifested after an average period of 11.17 months. The anatomic location of the OSCC within the maxillary structures (anterior vs posterior) and the histologic grade greatly influenced the occurrence of metastatic neck disease. No associations were found for the variables tumor size and resection status.
  
  
  CONCLUSIONS
  In this series, cervical lymph node metastases were frequent and to some degree predictable based on anatomic location and tumor grade.
authors.affiliation: Resident, Department of Oral and Maxillofacial Surgery, Ludwig Maximilians University of Munich, Munich, Germany. Electronic address: matthias_troeltzsch@hotmail.com.
authors.forename: Matthias
authors.initials: M
authors.lastname: Troeltzsch
authors.affiliation: Professor, Department of Pathology, Ludwig Maximilians University of Munich, Munich, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Knösel
authors.affiliation: Medical Oncologist, Department of Medicine, Division of Medical Oncology and Hematology, School of Medicine and Dentistry, University of Rochester; Unity Health System, Rochester, NY.
authors.forename: Timothy
authors.initials: T
authors.lastname: Woodlock
authors.affiliation: Resident, Department of Oral and Maxillofacial Surgery, Georg August University of Goettingen, Goettingen, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Troeltzsch
authors.affiliation: Medical Student, Department of Oral and Maxillofacial Surgery, Ludwig Maximilians University of Munich, Munich, Germany.
authors.forename: Alix
authors.initials: A
authors.lastname: Pianka
authors.affiliation: Resident, Department of Oral and Maxillofacial Surgery, Ludwig Maximilians University of Munich, Munich, Germany.
authors.forename: Florian Andreas
authors.initials: FA
authors.lastname: Probst
authors.affiliation: Consultant, Department of Oral and Maxillofacial Surgery, Ludwig Maximilians University of Munich, Munich, Germany.
authors.forename: Gerson
authors.initials: G
authors.lastname: Mast
authors.affiliation: Professor and Department Chair, Department of Oral and Maxillofacial Surgery, Ludwig Maximilians University of Munich, Munich, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Ehrenfeld
authors.affiliation: Consultant, Department of Oral and Maxillofacial Surgery, Ludwig Maximilians University of Munich, Munich, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Otto
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000556:secondary; D002423:Cause of Death; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008441:Maxillary Neoplasms / Q000473:pathology*; D008875:Middle Aged; D009333:Neck / Q000473:pathology; D037981:Neck Dissection / Q000379:methods; D020360:Neoadjuvant Therapy; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D010157:Palatal Neoplasms / Q000473:pathology; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors