J Korean Assoc Oral Maxillofac Surg 2017; 43(3): 166~170
Is elective neck dissection needed in squamous cell carcinoma of maxilla?
Jung-Hyun Park1,*, Woong Nam1, Hyung Jun Kim1, In-Ho Cha1,2
1Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry,
2Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, Korea
In-Ho Cha
Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea
TEL: +82-2-2228-3140 FAX: +82-2-2227-7825 E-mail: cha8764@yuhs.ac ORCID: http://orcid.org/0000-0001-8259-2190
*Current affiliation: Department of Oral and Maxillofacial Surgery, Ewha Womans University, Seoul, Korea
Received November 15, 2016; Revised January 19, 2017; Accepted February 5, 2017.; Published online June 30, 2017.
© Korean Association of Oral and Maxillofacial Surgeons. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Objectives: To define the risk of occult cervical metastasis of maxillary squamous cell carcinoma (SCC) and the therapeutic value of elective neck dissection (END) in survival of clinically negative neck node (cN0) patients.
Materials and Methods: Sixty-seven patients with maxillary SCC and cN0 neck were analyzed retrospectively, including 35 patients with maxillary gingiva and 32 patients with maxillary sinus.
Results: Of 67 patients, 10 patients (14.9%) had occult cervical metastasis. The incidence of occult cervical metastasis of maxillary gingival SCC was higher than that of maxillary sinus SCC (17.1% and 12.5%, respectively). The 5-year overall survival rate was 51.9% for the END group and 74.0% for the non-END group. The success rate of treatment for regional recurrence was high at 71.4%, whereas that for local or locoregional recurrence was low (33.3% and 0%, respectively).
Conclusion: The incidence of occult cervical metastasis of maxillary SCC was not high enough to recommend END. For survival of cN0 patients, local control of the primary tumor is more important than modality of neck management. Observation of cN0 neck is recommended when early detection of regional recurrence is possible irrespective of the site or T stage. The key enabler of early detection is patient education with periodic follow-up.
Keywords: Occult cervical metastasis, Squamous cell carcinoma, Maxillary gingiva, Maxillary sinus, Elective neck dissection


Current Issue

30 June 2017
Vol. 43
No. 3 pp. 145~212

Indexed in