Abstract
PurposeMetastases of squamous cell carcinoma of the tongue and the mouth floor have been well studied. Concerning maxilla squamous cell carcinomas, however, only a few studies have been performed. The question is whether a prophylactic neck dissection should be performed in these tumors.Patients and MaterialIn the Department of Craniomaxillofacial Surgery at the University Hospital of Zurich, 30 patients who had been treated for squamous cell carcinonoma of the maxilla were examined retrospectively. Special attention was paid to direct and late metastasis, survival rate, and treatment.ResultsOf the 59 patients with upper jaw carcinomas over a 9-year period, only about half (30 patients) had a squamous cell carcinoma of the upper jaw. Of those patients, 27% had an upper lesion on the right side, 33% on the left. Of the 11 patients (36.7%) presenting positive lymph nodes, 4 patients had direct positive lymph nodes while 7 patients had later positive lymph nodes; and 71.4% of the late metastasis appeared during the first year.ConclusionBecause of the 36.7% of patients presenting metastases in the cervical lymph nodes, elective neck treatment should be considered in cases even with a negative clinical examination.
Highlights
The estimated number of European patients with newly diagnosed cancers of the oral cavity and pharynx is 97,800 per year, and the estimated number of deaths because of these carcinomas is 40,100 in Europe per year
Because of the 36.7% of patients presenting metastases in the cervical lymph nodes, elective neck treatment should be considered in cases even with a negative clinical examination
Out of 30 patients with squamous cell carcinoma of the upper jaw, 11 patients (36.7%) presented positive lymph nodes, with direct positive lymph nodes in 4 patients and later positive lymph nodes in 7 patients (Fig. 2)
Summary
The estimated number of European patients with newly diagnosed cancers of the oral cavity and pharynx is 97,800 per year, and the estimated number of deaths because of these carcinomas is 40,100 in Europe per year. Squamous cell carcinoma is the most common type of tumor among cancers in the oral cavity. These tumors metastasize, usually through the lymphatic system, to cervical lymph nodes in levels I and II [2,3]. Several studies have been done on the metastasis of squamous cell carcinoma of the tongue/mouth floor and, in particular, on prophylactic neck dissection for tongue cancer [4]. It is well documented that patients with negative cervical lymph nodes have a good prognosis, but if lymph node metastasis occurs after excision of the primary tumor, the prognosis is poor
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