title: Impact of elective neck dissection on the outcome of oral squamous cell carcinomas arising in the maxillary alveolus and hard palate.
abstract: Whether elective lymph neck dissection (ELND) is associated with improved survival in oral squamous cell carcinomas (SCC) of the maxillary alveolus/hard palate is not known.
  
  
  
  One hundred ninety-nine patients presenting de novo and receiving treatment for clinically node negative SCC of the maxillary alveolus/hard palate at 2 cancer centers between 1985 and 2011 were analyzed.
  
  
  
  Forty-two patients (21%) received ELND. Occult nodal metastases were present in 29% of the dissected necks. The ELND group had more T3 to T4 status tumors (62% vs 34%; p < .001) and positive-margin resections (59% vs 38%; p = .019). Patients undergoing ELND experienced lower rates of neck recurrence (6% vs 21%; p = .031), superior 5-year recurrence-free survival (68% vs 45%; p = .026), and overall survival (86% vs 62%; p = .043). ELND was associated with a 2-fold decrease in risk of recurrence in multivariable analysis.
  
  
  
  ELND was associated with lower rates of recurrence and improved survival in SCC of the maxillary alveolus/hard palate. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1688-E1694, 2016.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, New York University, New York, New York.
authors.forename: Babak
authors.initials: B
authors.lastname: Givi
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network Toronto, Ontario, Canada.
authors.forename: Antoine
authors.initials: A
authors.lastname: Eskander
authors.affiliation: Head and Neck Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Mahmoud I
authors.initials: MI
authors.lastname: Awad
authors.affiliation: Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Qin
authors.initials: Q
authors.lastname: Kong
authors.affiliation: Head and Neck Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Pablo H
authors.initials: PH
authors.lastname: Montero
authors.affiliation: Head and Neck Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Frank L
authors.initials: FL
authors.lastname: Palmer
authors.affiliation: Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network Toronto, Ontario, Canada.
authors.forename: John R
authors.initials: JR
authors.lastname: De Almeida
authors.affiliation: Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Nancy
authors.initials: N
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: O'Sullivan
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network Toronto, Ontario, Canada.
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Irish
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network Toronto, Ontario, Canada.
authors.forename: Ralph
authors.initials: R
authors.lastname: Gilbert
authors.affiliation: Head and Neck Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Ian
authors.initials: I
authors.lastname: Ganly
authors.affiliation: Head and Neck Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Snehal G
authors.initials: SG
authors.lastname: Patel
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network Toronto, Ontario, Canada.
authors.forename: David P
authors.initials: DP
authors.lastname: Goldstein
authors.affiliation: Head and Neck Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Luc G T
authors.initials: LG
authors.lastname: Morris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008441:Maxillary Neoplasms / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010157:Palatal Neoplasms / Q000473:pathology / Q000601:surgery*; D021362:Palate, Hard / Q000473:pathology; D012189:Retrospective Studies
keywords: disease free survival; hard palate; lymphatic metastasis; maxillary neoplasms; neck dissection; squamous cell carcinoma of head and neck; treatment outcome