OP132: Cervical metastasis of maxillary squamous cell carcinoma

Abstract

The cervical treatment of squamous cell carcinoma (SCC) of maxilla is still in controversy. The purpose of this study was to determine the incidence of cervical metastasis of SCC of maxilla and evaluate the predictive factors of cervical metastasis. 133 consecutive patients with SCC of hard palate and maxillary alveolus from 2000 to 2009 in the department of Oral and Maxillofacial Surgery, Peking University School of Stomatology were reviewed. There were 65 patients underwent neck dissection. The clinical data of primary site, T-stage, histological grade and cervical lymph nodal metastasis were collected and analyzed. Among the 65 cases underwent neck dissection, maxillary alveolus was the primary subsite in 42 cases and hard palate in 23 cases. 22 patients were clinically examined nodal metastasis at present and 13 patients were confirmed as late metastasis. The overall incidence of cervical metastasis was 53.8%. Among all 35 N+ patients, positive lymph nodes were likely to be examined in level I (77.1%), II (60%) and III (11.4%), and level IV was involved only in one case, none was found in level V. The incidence of metastasis of maxillary alveolus (57.1%) was higher than that of hard palate (47.8%), but there is no significant difference ( p = 0.791). There are seven T1, 26 T2, nine T3 and 23 T4 tumors, the incidence of metastasis were 40%, 53.8%, 55.6%, and 60.9% respectively ( p = 0.228). The prevalence of metastasis of histological Grade1, Grade 2 and Grade3 tumors were 33.3%, 72% and 77.8% respectively ( p = 0.003). SCC of maxilla exhibits aggressive regional metastasis behavior. Levels I–III are most likely to be involved. There is significant relevance between histological grade and cervical lymph nodal metastasis of SCC of maxilla.