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Fang Q, Yuan J, Zhang X, Dai L, Luo R, Xu C. Oncologic and functional results between sentinel lymph node biopsy and elective neck dissection in cT1/2N0 maxillary squamous cell carcinoma. Oral Oncol 2024; 152:106810. [PMID: 38631065 DOI: 10.1016/j.oraloncology.2024.106810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 04/12/2024] [Accepted: 04/13/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVE To evaluate the oncologic safety and quality of life associated with the use of sentinel lymph node biopsy (SLNB) as compared to elective neck dissection (END) in patients with cT1/2N0 maxillary squamous cell carcinoma. METHODS This study constituted a retrospective analysis of consecutively treated patients who underwent SLNB or END, with data collected prospectively. We analyzed the impact of the different neck procedures on regional control and disease-specific survival via the Cox model. Patients in both groups completed the University of Washington Quality of Life questionnaire. RESULTS We included a total of 130 patients, with 47 receiving SLNB. In all cases, the sentinel lymph node could be identified, and of these, 5 had a positive result, yielding a sensitivity of 83.3 %, a specificity of 100 %, a false negative rate of 16.7 %, and a negative predictive value of 97.6 %. The sensitivity, specificity, false negative rate, and negative predictive value of END in detecting occult metastasis were 64.3 %, 100 %, 35.7 %, and 93.2 %, respectively. In comparison to END after propensity score matching, SLNB exhibited no significant difference in its effects on regional control (p = 0.519, HR: 1.05, 95 % CI: 0.52-1.93) and disease-specific survival (p = 0.634, HR: 1.22, 95 % CI: 0.53-1.99). Patients in SLNB group showed significantly higher mean scores of shoulder and taste domains at 3 months, 6 months, and 12 months postoperatively compared to those in END group. CONCLUSION SLNB could act as a viable alternative to END in cT1/2N0 maxillary squamous cell carcinoma with comparable prognosis and better quality of life.
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Affiliation(s)
- Qigen Fang
- Department of Head Neck and Thyroid, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China.
| | - Junhui Yuan
- Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
| | - Xu Zhang
- Department of Head Neck and Thyroid, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
| | - Liyuan Dai
- Department of Head Neck and Thyroid, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
| | - Ruihua Luo
- Department of Head Neck and Thyroid, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
| | - Chunmiao Xu
- Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
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Qayyum MU, Keerio AA, Faisal M, Rashid A, Hussain R, Jamshed A. Survival Outcomes and Patterns of Failure in Maxillary Alveolus Squamous Cell Carcinoma. Int Arch Otorhinolaryngol 2023; 27:e559-e564. [PMID: 37876703 PMCID: PMC10593516 DOI: 10.1055/s-0042-1758214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/05/2022] [Indexed: 10/26/2023] Open
Abstract
Introduction Squamous cell carcinoma (SCC) of the maxillary alveolus is a relatively rare disease. There is lack of data on this subsite as compared with other sites. The factors that affect survival in cases of maxillary alveolar SCC are tumor stage, local and cervical metastases, histological grading, and the margin status. Objectives To evaluate the overall survival (OS), the disease free survival (DFS), and the complex interaction and effects of margin status, histological differentiation, habits (such as smoking and the use of smokeless tobacco products), and cervical and distant metastases based on clinicopathological data. Methods We examined the electronic database at our hospital from 2003 to 2017. We included all cases with a histopathological diagnosis of SCC of the maxillary alveolus. Tumors originating primarily from the maxillary alveolus were included, while those originating from adjacent subsites, like the hard palate, the buccal mucosa or the maxillary sinus were excluded. We also excluded all the patients who were not operated on with a curative intent. Results More than half of the patients had stage-IV tumors at the time of presentation, while only one fourth of them had nodal metastasis. The rate of recurrence increased in cases of primary tumors in advanced stages and the degree of histological differentiation. The 2-year and 5-year OS rates were of 54.5% (18 patients) and 30.3% (10 patients) respectively. Conclusion Primary tumors in advanced stages, histological grade, and presence of nodal metastasis are poor prognostic markers in terms of long-term survival.
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Affiliation(s)
- Muhammad Umar Qayyum
- Department of Surgical Oncology–Head and Neck Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
- Department of Maxillofacial Surgery, Combined Military Hospital Lahore, Lahore, Pakistan
| | - Ahmed Ali Keerio
- Department of Surgical Oncology–Head and Neck Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Muhammad Faisal
- Department of Surgical Oncology–Head and Neck Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Asma Rashid
- Department of Surgical Oncology–Head and Neck Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Raza Hussain
- Department of Surgical Oncology–Head and Neck Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Arif Jamshed
- Department of Clinical and Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
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de la Fuente C, Prat-Valero N, Alberola-Ferranti M, Mis-Castell D, Sáez-Barba M, Pujol-Pina R, Pamias-Romero J, Bescós-Atín C. Occult metastases of oral maxillary squamous cell carcinoma: Systematic review and meta-analysis. Head Neck 2023; 45:733-744. [PMID: 36515647 DOI: 10.1002/hed.27276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 10/30/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
Squamous cell carcinoma (SCC) is the most common malignant neoplasm of the oral cavity. The performance of END (elective neck dissection) in cases of maxillary SCC is controversial because the literature traditionally classified maxillary tumors as having low metastatic potential. The aim of this systematic review and meta-analysis was to determine the percentage of occult cervical metastases in maxillary SCC to identify in which cases there is the need to perform an END. We searched the PubMed database to select articles dated from 2000 to 2020 that fulfilled our inclusion criteria; finally, we reviewed 27 manuscripts. We show that the overall cervical and occult metastases rate was 35% and 19%, respectively. For T1, the percentage of occult metastasis rate was 11%; for T2, it was 16%; for T3, it was 20%; and for T4, it was 32%. We suggest END (levels I-II-III) as treatment to T3/T4 cN0 patients.
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Affiliation(s)
- Carlos de la Fuente
- Servei de Cirurgia Oral i Maxil·lofacial, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,CIBBIM-Nanomedicine, Noves Tecnologies i Microcirurgia Craniofacial, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Nil Prat-Valero
- Servei de Cirurgia Oral i Maxil·lofacial, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,CIBBIM-Nanomedicine, Noves Tecnologies i Microcirurgia Craniofacial, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Margarita Alberola-Ferranti
- Servei d'Anatomia Patològica, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - David Mis-Castell
- Servei de Cirurgia Oral i Maxil·lofacial, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,CIBBIM-Nanomedicine, Noves Tecnologies i Microcirurgia Craniofacial, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Manel Sáez-Barba
- Servei de Cirurgia Oral i Maxil·lofacial, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,CIBBIM-Nanomedicine, Noves Tecnologies i Microcirurgia Craniofacial, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Rosa Pujol-Pina
- CIBBIM-Nanomedicine, Noves Tecnologies i Microcirurgia Craniofacial, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Jorge Pamias-Romero
- Servei de Cirurgia Oral i Maxil·lofacial, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,CIBBIM-Nanomedicine, Noves Tecnologies i Microcirurgia Craniofacial, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Coro Bescós-Atín
- Servei de Cirurgia Oral i Maxil·lofacial, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,CIBBIM-Nanomedicine, Noves Tecnologies i Microcirurgia Craniofacial, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
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Ohyama Y, Yamashiro M, Michi Y, Uzawa N, Myo K, Sonoda I, Sumino J, Miura C, Mizutani M, Yamamoto D, Kayamori K, Yoda T. Determination of Significant Prognostic Factors for Maxillary Gingival Squamous Cell Carcinoma in 90 Cases. Indian J Otolaryngol Head Neck Surg 2022; 74:5930-5935. [PMID: 36742798 PMCID: PMC9895216 DOI: 10.1007/s12070-021-02559-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 04/12/2021] [Indexed: 02/07/2023] Open
Abstract
Maxillary gingival squamous cell carcinoma (MGSCC) occurs rather infrequently, compared to tongue and mandibular gingival carcinomas, among the cancers of the oral cavity. Therefore, significant numbers of MGSCC cases have not been statistically analysed. The aim of this study is to clarify the prognostic factors for MGSCC. We performed the statistical analysis of 90 MGSCC cases primarily treated in our department from 1999 to 2014. The patients (male: 36, female: 54) were aged between 38 and 93 years, and the mean age was 68.7 years. The number of patients in each tumour stage according to the TNM classification was as follows: T1: 15 cases, T2: 32 cases, T3: 13 cases, and T4: 30 cases. Forty-two patients were treated only by surgery, 5 only by radiotherapy, 3 by preoperative radiotherapy and surgery, and 40 patients were treated by combination therapy with preoperative chemoradiotherapy and surgery. Neck dissections were performed in 40 cases including 29 cases (11 primary and 18 secondary cases) of histopathologically diagnosed lymph node metastases. Extranodal extension was found in 74.3% cases with metastatic lymph nodes. The 5-year overall survival rate was 81.9%. In univariate analysis, the site of occurrence, stage of tumour, lymph node metastasis, and treatment contributed to the 5-year survival rate. Multivariate analysis demonstrated that the site of occurrence (posterior region) was an independent prognostic factor. Seventeen deaths occurred due to the primary disease, while three deaths were caused by other diseases. The posterior region cancers, according to the classification based on site of occurrence, were independent predictors of poor 5-year overall survival rate.
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Affiliation(s)
- Yoshio Ohyama
- Department of Oral and Maxillofacial Surgery, Shizuoka City Shizuoka Hospital, 10-93, Outemachi, Aoi-ku, Shizuoka-shi, Shizuoka 420-8690 Japan
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45Bunkyo-ku, Yushima, Tokyo 113-8510 Japan
| | - Masashi Yamashiro
- Department of Dentistry and Oral Surgery, NTT Medical Center, 5-9-22 Higashigotannda, Shinagawa-ku, Tokyo 141-8625 Japan
| | - Yasuyuki Michi
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45Bunkyo-ku, Yushima, Tokyo 113-8510 Japan
| | - Narikazu Uzawa
- Department of Oral and Maxillofacial Surgery II, Osaka University, 1-8 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Kunihiro Myo
- Department of Head and Neck Surgery, Gunma Prefectural Cancer Center, 617-1 Takahayashinishi-cho, Oota-shi, Gunma 373-0828 Japan
| | - Itaru Sonoda
- Department of Dentistry and Oral Surgery, Moriyama Memorial, 4-3-1 Kitakasai, Edogawa-ku, Tokyo 134-0081 Japan
| | - Jun Sumino
- Department of Oral Surgery, Saitama Cancer Center, 780, Komuro, Inamachi, Kitaadachigun, Saitama 362-0806 Japan
| | - Chika Miura
- Department of Oral Surgery, Japanese Red Cross Aahikaga Hospital, 284-1 Yobe-cho, Ashikaga, Tochigi 326-0843 Japan
| | - Miho Mizutani
- Department of Dentistry and Oral Surgery, NTT Medical Center, 5-9-22 Higashigotannda, Shinagawa-ku, Tokyo 141-8625 Japan
| | - Daisuke Yamamoto
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45Bunkyo-ku, Yushima, Tokyo 113-8510 Japan
| | - Kou Kayamori
- Department of Oral Pathology, Tokyo Medical and Dental University, 1-5-45Bunkyo-ku, Yushima, Tokyo 113-8510 Japan
| | - Tetsuya Yoda
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45Bunkyo-ku, Yushima, Tokyo 113-8510 Japan
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Contrera KJ, Huang AT, Shenson JA, Tang C, Roberts D, Myers JN, Weber RS, Lai SY, Williams M, El-Hallal M, Jacob D, Zafereo M. Primary and recurrent regional metastases for lateralized oral cavity squamous cell carcinoma. Surg Oncol 2022; 44:101804. [DOI: 10.1016/j.suronc.2022.101804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 05/17/2022] [Accepted: 07/03/2022] [Indexed: 10/16/2022]
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Doll C, Mrosk F, Wuester J, Runge AS, Neumann F, Rubarth K, Heiland M, Kreutzer K, Voss J, Raguse JD, Koerdt S. Pattern of cervical lymph node metastases in squamous cell carcinoma of the upper oral cavity – How to manage the neck. Oral Oncol 2022; 130:105898. [DOI: 10.1016/j.oraloncology.2022.105898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 11/29/2022]
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Kovalski LNS, Zanella VG, Jardim LC, Só BB, Girardi FM, Kroef RG, Barra MB, Carrard VC, Martins MD, Martins MAT. Prognostic factors from squamous cell carcinoma of the hard palate, gingiva and upper alveolar ridge. Braz Oral Res 2022; 36:e058. [PMID: 36507745 DOI: 10.1590/1807-3107bor-2022.vol36.0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 01/12/2022] [Indexed: 12/24/2022] Open
Abstract
The purpose of this study was to evaluate the clinicodemographic characteristics and treatment protocol as prognostic factors in patients with oral squamous cell carcinoma (OSCC) of the hard palate, upper gingiva, and alveolar ridge (HPUGAR). This retrospective cohort study collected data of patients treated in two head and neck surgery departments in southern Brazil between 1999 and 2021. Information on clinicodemographic data, habits, site, size, clinical aspect, clinical staging, cervical metastasis, treatment, and survival was collected. Associations between independent variables and outcomes were assessed using Pearson's chi-square test and binary regression. Kaplan-Meier test was employed to compare the survival between the neck approaches. Forty-one patients were included; most were male (61%), with a mean age of 68.8 (± 13.9) years. The consumption of tobacco (p = 0.003) and alcohol (p = 0.02) was significantly higher in male than in female patients. The main clinical features observed in the study sample were lesions larger than 2 cm (48.7%), no cervical (90.2%), or distant metastasis (90.2%). Surgery alone was the main treatment approach (48.8%). The watch-and-wait strategy was adopted in 34 cases (83.0%), while elective neck dissection was applied in five (12.2%). Only two patients with cN0 disease (4.9%) presented with cervical metastasis at follow-up. Eight patients (12.2%) died of the disease. Clinicodemographic variables, habits, surgical margins, and histological subtype were not significantly associated with cervical metastasis or survival. Cervical metastasis (p = 0.004) was associated with poor survival. No difference was detected in survival between different neck approaches (p = 0.28). Cervical metastasis and local recurrence are negative prognostic factors for HPUGAR OSCC.
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Affiliation(s)
- Luan Nathiel Santana Kovalski
- Universidade Federal do Rio Grande do Sul - UFRGS, Department of Oral Pathology and Oral Medicine, Porto Alegre, RS, Brazil
| | - Virgilio Gonzalez Zanella
- Complexo Hospitalar Santa Casa, Hospital Santa Rita, Department of Head and Neck Surgery, Porto Alegre, RS, Brazil
| | - Luisa Comerlato Jardim
- Universidade Federal do Rio Grande do Sul - UFRGS, Department of Oral Pathology and Oral Medicine, Porto Alegre, RS, Brazil
| | - Bruna Barcelos Só
- Universidade Federal do Rio Grande do Sul - UFRGS, Department of Oral Pathology and Oral Medicine, Porto Alegre, RS, Brazil
| | - Fabio Muradás Girardi
- Hospital Ana Nery, Department of Head and Neck Surgery, Santa Cruz do Sul, RS, Brazil
| | - Ricardo Gallicchio Kroef
- Complexo Hospitalar Santa Casa, Hospital Santa Rita, Department of Head and Neck Surgery, Porto Alegre, RS, Brazil
| | - Marinez Bizarro Barra
- Complexo Hospitalar Santa Casa, Hospital Santa Rita, Deparment of Pathology, Porto Alegre, RS, Brazil
| | - Vinicius Coelho Carrard
- Universidade Federal do Rio Grande do Sul - UFRGS, Hospital de Clínicas de Porto Alegre, Department of Oral Medicine, Porto Alegre, RS, Brazil
| | - Manoela Domingues Martins
- Universidade Federal do Rio Grande do Sul - UFRGS, Department of Oral Pathology and Oral Medicine, Porto Alegre, RS, Brazil
| | - Marco Antonio Trevizani Martins
- Universidade Federal do Rio Grande do Sul - UFRGS, Hospital de Clínicas de Porto Alegre, Department of Oral Medicine, Porto Alegre, RS, Brazil
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Aldosimani M, Verdonschot RG, Iwamoto Y, Nakazawa M, Mallya SM, Kakimoto N, Toyosawa S, Kreiborg S, Murakami S. Prognostic factors for lymph node metastasis from upper gingival carcinomas. Oral Radiol 2021; 38:389-396. [PMID: 34559370 PMCID: PMC9200680 DOI: 10.1007/s11282-021-00568-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 09/13/2021] [Indexed: 12/02/2022]
Abstract
Objectives This study sought to identify tumor characteristics that associate with regional lymph node metastases in squamous cell carcinomas originating in the upper gingiva. Materials and methods Data from 113 patients from Osaka University Dental Hospital were included. We measured each primary tumor’s width, length, depth, and the extent of bone invasion. Additionally, tumor signal intensity for T1 and T2-weighted images as well as the center of the tumor’s location and T classification was assessed, and a histopathological analysis was performed. Results Tumor signal intensity was not found to be a significant prognostic factor. However, bucco-lingual width, histopathological classification as well as the tumor’s location were significantly different between metastatic and non-metastatic groups in both univariate and multivariate analysis. Superior–inferior depth and T classification were significant only in the univariate (and not the multivariate) analysis. Conclusions Bucco-lingual width, histopathological grading as well as the tumor’s location are likely to be important predictors for the occurrence of LN metastasis in upper gingival carcinoma patients and should be considered when managing care for these patients.
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Affiliation(s)
- Mazen Aldosimani
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
- Division of Radiology, Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Rinus G Verdonschot
- Department of Oral and Maxillofacial Radiology, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
- Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands.
| | - Yuri Iwamoto
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Mitsuhiro Nakazawa
- Oral and Maxillofacial Surgery II, Graduate School of Dentistry, Osaka University, Suita, Japan
| | - Sanjay M Mallya
- Section of Oral and Maxillofacial Radiology, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Naoya Kakimoto
- Department of Oral and Maxillofacial Radiology, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Satoru Toyosawa
- Department of Oral Pathology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Sven Kreiborg
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
- 3D Craniofacial Image Research Laboratory, University of Copenhagen, Copenhagen, Denmark
| | - Shumei Murakami
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
- Department of Oral Pathology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
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Chia C, Key S, Hasan Z, Virk S, Riffat F. Systematic review and meta-analysis of cervical metastases in oral maxillary squamous cell carcinoma. Cancer Rep (Hoboken) 2021; 4:e1410. [PMID: 33963809 PMCID: PMC8714539 DOI: 10.1002/cnr2.1410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/05/2021] [Accepted: 03/25/2021] [Indexed: 12/30/2022] Open
Abstract
Background Management of the node‐negative neck in oral maxillary squamous cell carcinoma (SCC), encompassing the hard palate and upper alveolar subsites of the oral cavity, is controversial, with no clear international consensus or recommendation regarding elective neck dissection in the absence of cervical metastases. Aim To assess the occult metastatic rate in patients with clinically node negative oral maxillary SCC; both as an overall metastatic rate, and a comparison of patients managed with an elective neck dissection at index surgery, compared to excision of the primary with clinical observation of the neck. Methods and results A systematic review was performed by two independent investigators for studies relating to oral maxillary SCC and analysed according to PRISMA criteria. Data were extracted from Pubmed, Ovid MEDLINE, EMBASE, and SCOPUS via relevant MeSH terms. Grey literature was searched through Google Scholar and OpenGrey. Five hundred and fifty‐three articles were identified on the initial search, 483 unique articles underwent screening against eligibility criteria, and 29 studies were identified for final data extraction. Incidence of occult metastases in patients with clinically node negative oral maxillary SCC was identified either on primary elective neck dissection or on routine follow up. Meta‐analyses were performed. Of 553 relevant articles identified on initial search, 29 were included for analysis. The pooled overall rate of occult metastases in patients initially presenting with clinically node‐negative disease was 22.2%. There is a statistically significant effect of END on decreasing regional recurrence demonstrated in this study (RR 0.36, 95% CI 0.24, 0.59). Conclusion The results of this systematic review and meta‐analysis suggest elective neck dissection for patients presenting with hard palate or upper alveolar SCC, even in a clinically node negative neck.
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Affiliation(s)
| | | | - Zubair Hasan
- Monash Health, Clayton, Victoria, Australia.,Westmead Hospital, Westmead, New South Wales, Australia.,University of Sydney, Camperdown, New South Wales, Australia
| | - Sohaib Virk
- University of New South Wales, Randwick, New South Wales, Australia
| | - Faruque Riffat
- University of Sydney, Camperdown, New South Wales, Australia.,Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.,Macquarie University Hospital, Macquarie University, Macquarie Park, New South Wales, Australia
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Ibrahim SA, Ahmed ANA, Elsersy HA, Darahem IMH. Elective neck dissection in T1/T2 oral squamous cell carcinoma with N0 neck: essential or not? A systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2020; 277:1741-1752. [PMID: 32100133 DOI: 10.1007/s00405-020-05866-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 02/12/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Oral squamous cell carcinoma (SCC) is characterized by a high risk of cervical lymph node metastasis with a high incidence of occult metastasis. A strong debate is still present regarding the best treatment for early oral cavity cancer with N0 neck. OBJECTIVE The aim of the present study was to compare between the results of elective neck dissection (END) and watchful waiting (observation or therapeutic neck dissection) in patients with early-stage (T1/T2) oral squamous cell carcinoma with N0 neck. DATA SOURCES Medline database (https://www.pubmed.com), Google Scholar and Scopus. PATIENTS AND METHODS A systematic review and meta-analysis for the evaluation of regional recurrence rate and 5-year survival rate after elective neck dissection (END) or watchful waiting in early oral cancers were conducted. This study included published English medical articles (which met our predetermined inclusion criteria) in the last 30 years, concerning early oral SCC with N0 neck. 24 articles were included (4 randomized studies and 20 observational "retrospective" studies) with a total number of 2190 of patients who underwent END and 1619 who underwent watchful waiting. Regarding the 5-year survival rate, (10) studies were included with a total number of 1211 patients who underwent END and 948 who underwent watchful waiting. RESULTS Regarding the regional recurrence rate, (END) was associated with significantly lower risk of recurrence when compared with observation. Regarding the 5-year survival rate, END was associated with a better survival rate than the observational group. CONCLUSIONS Elective neck dissection is better than watchful waiting in early (T1/T2) stage oral cavity squamous cell carcinoma with N0 neck, regarding regional recurrence and 5-year survival rate.
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Affiliation(s)
- Samer Ahmed Ibrahim
- Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, 6th Nile Valley Street, Hadayek Alkoba, Cairo, 11331, Egypt
| | - Ahmed Nabil Abdelhamid Ahmed
- Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, 6th Nile Valley Street, Hadayek Alkoba, Cairo, 11331, Egypt.
| | - Hisham Abdelaty Elsersy
- Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, 6th Nile Valley Street, Hadayek Alkoba, Cairo, 11331, Egypt
| | - Islam Mohammed Hussein Darahem
- Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, 6th Nile Valley Street, Hadayek Alkoba, Cairo, 11331, Egypt
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12
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Hayashi Y, Osawa K, Nakakaji R, Minamiyama S, Ohashi N, Ohya T, Iida M, Iwai T, Ozawa T, Oguri S, Koizumi T, Hirota M, Kioi M, Hata M, Mitsudo K. Prognostic factors and treatment outcomes of advanced maxillary gingival squamous cell carcinoma treated by intra-arterial infusion chemotherapy concurrent with radiotherapy. Head Neck 2019; 41:1777-1784. [PMID: 30694002 DOI: 10.1002/hed.25607] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 10/20/2018] [Accepted: 12/10/2018] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the prognostic factors and treatment outcomes of advanced maxillary gingival squamous cell carcinoma (SCC) treated with intra-arterial infusion chemotherapy concurrent with radiotherapy. METHODS A total of 46 patients were reviewed retrospectively in this study. The treatment schedule comprised intra-arterial chemotherapy (total, 60 mg/m2 docetaxel and 150 mg/m2 cisplatin) and three-dimensional computed tomography based, daily conventional radiotherapy (total, 60 Gy/30 fr) for 6 weeks. RESULTS The median follow-up period was 40 months (range, 3-110 months). The 3-year overall survival and locoregional control rates for all patients were 64.3% and 84.3%, respectively. The OS rate of the patients with N0-1 was significantly higher than that of the patients with N ≥ 2 (P < .05). No grade 5 toxicities were observed. CONCLUSIONS Intra-arterial infusion chemotherapy concurrent with radiotherapy was effective for advanced maxillary gingival SCC.
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Affiliation(s)
- Yuichiro Hayashi
- Departments of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan
| | - Kohei Osawa
- Departments of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan
| | - Rina Nakakaji
- Departments of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan
| | - Shuhei Minamiyama
- Departments of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan
| | - Nobuhide Ohashi
- Departments of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan
| | - Takashi Ohya
- Departments of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan
| | - Masaki Iida
- Departments of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan
| | - Toshinori Iwai
- Departments of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan
| | - Tomomichi Ozawa
- Department of Dentistry and Oral Surgery, Yamato Municipal Hospital, Yamato City, Kanagawa, Japan
| | - Senri Oguri
- Departments of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan
| | - Toshiyuki Koizumi
- Departments of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan
| | - Makoto Hirota
- Departments of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan
| | - Mitomu Kioi
- Departments of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan
| | - Masaharu Hata
- Departments of Radiation Oncology, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan
| | - Kenji Mitsudo
- Departments of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan
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Cariati P, Cabello-Serrano A, Monsalve-Iglesias F, Fernadez-Solis J, Martinez-Lara I. Is a "watch and wait strategy" safe to manage clinically N0 squamous cell carcinoma of the upper jaw? Curr Probl Cancer 2018; 43:336-343. [PMID: 30447879 DOI: 10.1016/j.currproblcancer.2018.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 10/11/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE The main aim of the present study is to analyze the behavior of squamous cell carcinoma (SCC) of maxillary gingiva, alveolus, and hard palate and to determine the utility of selective neck dissection in clinically N0 patients at early stages. MATERIAL AND METHOD Twenty-nine previously untreated patients with SCC of maxillary gingiva, alveolus, and hard palate were diagnosed and treated with at least a tumorectomy and selective neck dissection at HUVN and included in the study. RESULTS A total of 34.4% of patients (10/29) showed nodal involvement at postoperative histopathologic exam. Several pathologic features such as N involvement, N stage, T stage, and locoregional failure all have a negative impact on overall survival. DISCUSSION SCC of maxillary gingiva, alveolus, and hard palate shows an aggressive behavior that is comparable with other oral cavity cancers. A more aggressive treatment is thus required for improving locoregional control and overall survival. Supraomohyoid neck dissection may be useful in cT2N0M0.
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Segna E, Bolzoni A, Giannì A, Baj A, Beltramini G. Impact of reconstructive microsurgery on patients with cancer of the head and neck: a prospective study of quality of life, particularly in older patients. Br J Oral Maxillofac Surg 2018; 56:830-834. [DOI: 10.1016/j.bjoms.2018.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 09/07/2018] [Indexed: 11/30/2022]
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Abstract
Management of oral cavity squamous cell carcinoma has become increasingly driven by emerging evidence as a result of the improved quality of clinical research associating clinicopathologic risk factors with oncologic and survival outcomes. Multiple significant recent changes to treatment guidelines and staging algorithms for oral cavity squamous cell carcinoma reflect evolving understanding of tumor biology and the need for adequately extensive treatment of aggressive disease. This article provides clinicians with a synopsis of the most contemporary management strategies for oral cavity squamous cell carcinoma, framed within the context of historical treatment philosophies.
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Affiliation(s)
- Kyle S Ettinger
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Section of Head and Neck Oncologic Surgery and Reconstruction, Mayo Clinic, Mayo College of Medicine, Mail Code: ro_ma_12_12econ, 200 First Street Southwest, Rochester, MN 55905, USA; Department of Oral and Maxillofacial Surgery, Division of Head and Neck Surgery, University of Florida College of Medicine - Jacksonville, 653-1 West 8th Street 2nd FL/LRC, Jacksonville, FL 32209, USA
| | - Laurent Ganry
- Department of Oral and Maxillofacial Surgery, Division of Head and Neck Surgery, University of Florida College of Medicine - Jacksonville, 653-1 West 8th Street 2nd FL/LRC, Jacksonville, FL 32209, USA; Department of Maxillo-facial, Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France
| | - Rui P Fernandes
- Division of Head and Neck Surgery, Head and Neck Oncologic Surgery and Microvascular Reconstruction Fellowship, Department of Oral and Maxillofacial Surgery, University of Florida College of Medicine - Jacksonville, University of Florida - Jacksonville, 653-1 West 8th Street 2nd FL/LRC, Jacksonville, FL 32209, USA.
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Moratin J, Fuchs A, Zeidler C, Müller-Richter UD, Brands RC, Hartmann S, Kübler AC, Linz C. Squamous cell carcinoma of the maxilla: Analysis of clinicopathological predictors for disease recurrence and metastatic behavior. J Craniomaxillofac Surg 2018; 46:611-616. [DOI: 10.1016/j.jcms.2018.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 12/28/2017] [Accepted: 01/15/2018] [Indexed: 10/18/2022] Open
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Kwon IJ, Kim SM. Importance of elective neck dissection in cN0 maxillary squamous cell carcinoma. J Korean Assoc Oral Maxillofac Surg 2018. [PMID: 29535968 PMCID: PMC5845967 DOI: 10.5125/jkaoms.2018.44.1.34] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Ik Jae Kwon
- Department of Oral and Maxillofacial Surgery, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| | - Soung Min Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
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Deneuve S, Bodard AG, Delquignies E, Janot F, Zrounba P, Julieron M. Can Early Dissection of Cervical Lymph Nodes Improve Prognosis in Squamous Cell Carcinomas of the Hard Palate. ORL J Otorhinolaryngol Relat Spec 2017; 79:314-322. [DOI: 10.1159/000480351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 08/14/2017] [Indexed: 11/19/2022]
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19
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Park JH, Nam W, Kim HJ, Cha IH. Is elective neck dissection needed in squamous cell carcinoma of maxilla? J Korean Assoc Oral Maxillofac Surg 2017; 43:166-170. [PMID: 28770157 PMCID: PMC5529190 DOI: 10.5125/jkaoms.2017.43.3.166] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 01/19/2017] [Accepted: 02/05/2017] [Indexed: 11/25/2022] Open
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.
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Affiliation(s)
- Jung-Hyun Park
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Korea
| | - Woong Nam
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Korea
| | - Hyung Jun Kim
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Korea
| | - In-Ho Cha
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Korea.,Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, Korea
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20
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Joosten MH, de Bree R, Van Cann EM. Management of the clinically node negative neck in squamous cell carcinoma of the maxilla. Oral Oncol 2017; 66:87-92. [DOI: 10.1016/j.oraloncology.2016.12.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 11/27/2016] [Accepted: 12/27/2016] [Indexed: 10/20/2022]
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21
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Boeve K, Schepman K, van der Vegt B, Schuuring E, Roodenburg JL, Brouwers AH, Witjes MJ. Lymphatic drainage patterns of oral maxillary tumors: Approachable locations of sentinel lymph nodes mainly at the cervical neck level. Head Neck 2016; 39:486-491. [DOI: 10.1002/hed.24628] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 08/02/2016] [Accepted: 10/07/2016] [Indexed: 11/09/2022] Open
Affiliation(s)
- Koos Boeve
- Department of Oral and Maxillofacial SurgeryUniversity of Groningen, University Medical Center GroningenGroningen The Netherlands
- Department of PathologyUniversity of Groningen, University Medical Center GroningenGroningen The Netherlands
| | - Kees‐Pieter Schepman
- Department of Oral and Maxillofacial SurgeryUniversity of Groningen, University Medical Center GroningenGroningen The Netherlands
| | - B van der Vegt
- Department of PathologyUniversity of Groningen, University Medical Center GroningenGroningen The Netherlands
| | - Ed Schuuring
- Department of PathologyUniversity of Groningen, University Medical Center GroningenGroningen The Netherlands
| | - Jan L. Roodenburg
- Department of Oral and Maxillofacial SurgeryUniversity of Groningen, University Medical Center GroningenGroningen The Netherlands
| | - Adrienne H. Brouwers
- Department of Nuclear Medicine and Molecular ImagingUniversity of Groningen, University Medical Center GroningenGroningen The Netherlands
| | - Max J. Witjes
- Department of Oral and Maxillofacial SurgeryUniversity of Groningen, University Medical Center GroningenGroningen The Netherlands
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When should elective neck dissection be performed in maxillary gingival and alveolar squamous cell carcinoma with a cN0 neck? A systematic review. Int J Oral Maxillofac Surg 2016; 45:1358-1365. [DOI: 10.1016/j.ijom.2016.05.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 05/13/2016] [Accepted: 05/26/2016] [Indexed: 11/22/2022]
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23
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Os ADV, Karakullukcu B, Leemans CR, Halmos GB, Roodenburg JLN, Weert SV, Karagozoglu KH, Witjes MJH. Management of the clinically N0 neck in squamous cell carcinoma of the maxillary alveolus and hard palate. Head Neck 2016; 38:1794-1798. [DOI: 10.1002/hed.24511] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 02/26/2016] [Accepted: 05/05/2016] [Indexed: 02/05/2023] Open
Affiliation(s)
- Alejandra D. van Os
- Department of Head and Neck Oncology and Surgery; The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital; Amsterdam The Netherlands
| | - Baris Karakullukcu
- Department of Head and Neck Oncology and Surgery; The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital; Amsterdam The Netherlands
| | - C. René Leemans
- Department of Otolaryngology - Head and Neck Surgery; VU University Medical Centre and Cancer Center; Amsterdam The Netherlands
| | - Gyorgy B. Halmos
- Department of Otorhinolaryngology / Head and Neck Surgery; University of Groningen, University Medical Center Groningen; The Netherlands
| | - Jan L. N. Roodenburg
- Department of Oral and Maxillofacial Surgery; University of Groningen, University Medical Center Groningen; The Netherlands
| | - Stijn van Weert
- Department of Otolaryngology - Head and Neck Surgery; VU University Medical Centre and Cancer Center; Amsterdam The Netherlands
| | - K. Hakki Karagozoglu
- Department of Oral and Maxillofacial Surgery and Oral Pathology, VU University Medical Center; Amsterdam The Netherlands
| | - Max J. H. Witjes
- Department of Oral and Maxillofacial Surgery; University of Groningen, University Medical Center Groningen; The Netherlands
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Zhang WB, Peng X. Cervical metastases of oral maxillary squamous cell carcinoma: A systematic review and meta-analysis. Head Neck 2016; 38 Suppl 1:E2335-42. [PMID: 26890607 DOI: 10.1002/hed.24274] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Revised: 07/17/2015] [Accepted: 09/12/2015] [Indexed: 11/08/2022] Open
Affiliation(s)
- Wen-Bo Zhang
- Department of Oral and Maxillofacial Surgery; Peking University School and Hospital of Stomatology; Haidian District Beijing China
| | - Xin Peng
- Department of Oral and Maxillofacial Surgery; Peking University School and Hospital of Stomatology; Haidian District Beijing China
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25
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Green B, Bisase B, Godden D, Mitchell DA, Brennan PA. Current surgical management of metastases in the neck from mucosal squamous cell carcinoma of the head and neck. Br J Oral Maxillofac Surg 2016; 54:135-40. [DOI: 10.1016/j.bjoms.2015.06.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 06/30/2015] [Indexed: 01/17/2023]
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26
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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. J Oral Maxillofac Surg 2016; 74:79-86. [DOI: 10.1016/j.joms.2015.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 07/12/2015] [Accepted: 07/14/2015] [Indexed: 11/23/2022]
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Berger M, Grau E, Saure D, Ristow O, Thiele O, Hofele C, Hoffmann J, Seeberger R, Freier K. Occurrence of cervical lymph node metastasis of maxillary squamous cell carcinoma – A monocentric study of 171 patients. J Craniomaxillofac Surg 2015; 43:2195-9. [DOI: 10.1016/j.jcms.2015.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 09/17/2015] [Accepted: 09/25/2015] [Indexed: 10/22/2022] Open
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Tumour–node–metastasis staging of human papillomavirus negative upper aerodigestive tract cancers: a critical appraisal. J Laryngol Otol 2015; 129:1148-55. [DOI: 10.1017/s0022215115002686] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjective:The tumour–node–metastasis staging system has a dynamic structure that is continuously being updated as scientific data develops. This review discusses some suggested revisions on tumour–node–metastasis staging of human papillomavirus negative upper aerodigestive tract cancers.Methods:The seventh edition of The American Joint Committee on Cancer Staging Manual was reviewed and important issues that could be considered for revision were identified and discussed.Results:According to our assessment of the oncological outcomes of previous studies, the following factors should be considered for revision: anterior commissure involvement and subglottic extension in laryngeal cancers; underlying bone involvement in hard palate and upper alveolar ridge cancers; tumour thickness in oral cancers; and extracapsular spread and carotid artery involvement in neck metastases.Conclusion:Sufficient data on the prognostic importance of these issues have been reported. Suggested revisions in line with current knowledge on the clinical behaviour of upper aerodigestive tract cancers would improve the relevancy of staging.
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Clinicopathological Characteristics and Outcome Predictors in Squamous Cell Carcinoma of the Maxillary Gingiva and Hard Palate. J Oral Maxillofac Surg 2015; 73:1429-36. [DOI: 10.1016/j.joms.2014.12.034] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 12/18/2014] [Accepted: 12/23/2014] [Indexed: 12/16/2022]
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Zhang W, Wang Y, Mao C, Guo C, Yu G, Peng X. Cervical metastasis of maxillary squamous cell carcinoma. Int J Oral Maxillofac Surg 2015; 44:285-91. [DOI: 10.1016/j.ijom.2014.10.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 09/16/2014] [Accepted: 10/23/2014] [Indexed: 10/24/2022]
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Bark R, Mercke C, Munck-Wikland E, Wisniewski NA, Hammarstedt-Nordenvall L. Cancer of the gingiva. Eur Arch Otorhinolaryngol 2015; 273:1335-45. [PMID: 25649283 DOI: 10.1007/s00405-015-3516-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 01/19/2015] [Indexed: 10/24/2022]
Abstract
Cancer of the gingiva is a rare disease in the Western World. It most commonly affects elderly population. Because of its rarity, the reporting on the disease is sparse and often grouped with other subsites of oral cancer, which makes conclusions difficult to interpret. The aim of this paper is to review the literature on gingival cancer as a specific subsite of oral cancer and report on published prognostic factors as well as treatment of local and regional disease. We also present differences between gingival cancer subgroups, mandibular and maxillary gingival cancer. In addition, both surgical and oncological treatments are reviewed. It seems that surgery is the preferred initial treatment approach for the majority of patients with gingival cancer, although adjuvant radiation, with or without chemotherapy, is commonly recommended to increase locoregional control.
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Affiliation(s)
- Rusana Bark
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, S-171 76, Stockholm, Sweden. .,Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Karolinska University Hospital, 17176, Stockholm, Sweden.
| | - Claes Mercke
- Department of Oncology-Pathology, Karolinska Institutet, Karolinska University Hospital, S-171 76, Stockholm, Sweden
| | - Eva Munck-Wikland
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, S-171 76, Stockholm, Sweden
| | | | - Lalle Hammarstedt-Nordenvall
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, S-171 76, Stockholm, Sweden
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Yanamoto S, Yamada S, Takahashi H, Naruse T, Shigeta T, Minamikawa T, Shibuya Y, Komori T, Umeda M. Benefits of maxillectomy with internal dissection of the masticator space by transmandibular approach in the surgical management of malignant tumours of the upper gingiva and hard palate: a clinical review of 10 cases. Int J Oral Maxillofac Surg 2014; 43:1319-25. [DOI: 10.1016/j.ijom.2014.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 05/02/2014] [Accepted: 06/10/2014] [Indexed: 11/26/2022]
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Philip J, James R. Maxillary squamous cell carcinoma: an 11-year retrospective study of one regional cancer centre. Int J Oral Maxillofac Surg 2014; 43:1195-8. [DOI: 10.1016/j.ijom.2014.05.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 05/18/2014] [Accepted: 05/26/2014] [Indexed: 11/16/2022]
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Feng Z, Li JN, Li CZ, Guo CB. Elective neck dissection versus observation in the management of early tongue carcinoma with clinically node-negative neck: A retrospective study of 229 cases. J Craniomaxillofac Surg 2014; 42:806-10. [DOI: 10.1016/j.jcms.2013.11.016] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Revised: 09/13/2013] [Accepted: 11/11/2013] [Indexed: 11/29/2022] Open
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Feng Z, Niu LX, Yuan Y, Peng X, Guo CB. Risk factors and treatment of contralateral neck recurrence for unilateral oral squamous cell carcinoma: a retrospective study of 1482 cases. Oral Oncol 2014; 50:1081-8. [PMID: 25156479 DOI: 10.1016/j.oraloncology.2014.08.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 07/25/2014] [Accepted: 08/07/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND The aim of this study was to describe risk factors of contralateral neck recurrence (CLNR) and to identify its high-risk population after treatment for unilateral oral squamous cell carcinoma. METHODS Between June 1991 and June 2012, a total of 1482 eligible patients who were treated with radical surgery with or without adjuvant therapy were retrospectively reviewed. RESULTS The outcome assessment parameters were the rate of 5-year CLNR and the rate of disease-specific survival (DSS). In the entire study cohort, the 5-year CLNR rate was 4.1%. In a multivariate analysis, only extracapsular spread (ECS) status (hazard ratio [HR]: 12.978, 95% confidence interval [CI]: 1.328-126.829, P=0.028) was an independent risk factor for 5-year CLNR. In addition, 5-year CLNR (HR: 36.410, 95% CI: 7.093-186.914, P<0.001), T stage (HR: 3.475, 95% CI: 1.151-10.488, P=0.027) and growth pattern (HR: 4.831, 95% CI: 1.776-13.140, P=0.002) were independent risk factors for 5-year DSS. Patients with at least two risk factors were identified as a high-risk population for CLNR; these patients also had a poor prognosis. Elective contralateral neck dissection (ND) plus concurrent chemoradiotherapy (CCRT) can improve the 5-year DSS in these high-risk patients, but it does not decrease the 5-year CLNR rate. CONCLUSION For low- and moderate-risk patients, contralateral neck observation should be considered sufficient if strict compliance with a cancer surveillance protocol is followed. However, whether high-risk patients benefit from contralateral ND plus adjuvant CCRT can only be answered in a prospective trial.
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Affiliation(s)
- Zhien Feng
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Peking University, Beijing 100081, China
| | - Li Xuan Niu
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Peking University, Beijing 100081, China
| | - Yuan Yuan
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Peking University, Beijing 100081, China
| | - Xin Peng
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Peking University, Beijing 100081, China
| | - Chuan Bin Guo
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Peking University, Beijing 100081, China.
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High MMP-21 expression in metastatic lymph nodes predicts unfavorable overall survival for oral squamous cell carcinoma patients with lymphatic metastasis. Oncol Rep 2014; 31:2644-50. [PMID: 24700287 DOI: 10.3892/or.2014.3124] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 02/22/2014] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to examine the clinical significance of lymph node metastatic (LNM) foci in predicting the overall survival of oral squamous cell carcinoma (OSCC) patients with LNM. MMP-21 was screened based on the LNM animal model of OSCC. Then four proteins, matrix metalloproteinase (MMP)-2, MMP-21, vascular endothelial growth factor (VEGF)-C and VEGF receptor (VEGFR)-3 were examined by immunohistochemistry in 63 OSCC specimens, including the primary tumors (PTs) and the corresponding LNM foci. The expression levels between the PTs and LNM foci were compared by Wilcoxon paired test. Relationships between expression of the four proteins and patient overall survival were assessed by Kaplan-Meier based on the median of the labeling index. The Cox proportional hazards model was used to assess the relative hazard factors. MMP-21 and VEGF-C expression levels were higher in the LNM foci than levels in the PTs. Results showed that MMP-2 and VEGF-C expression levels in the PTs and MMP-2, MMP-21 and VEGF-C expression in the LNM foci correlated with the overall survival of the OSCC patients with lymphatic metastasis. MMP-21 expression level in the LNM foci was the most reliable predictor among all the tested factors. These results suggest that high MMP-21 expression in LNM foci can be used to predict survival in OSCC patients with LNM. Characteristics of LNM foci may be more reliable than PT characteristics in predicting the overall survival of OSCC patients with lymphatic metastasis.
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Ohba S, Yoshimura H, Matsuda S, Imamura Y, Sano K. Spindle cell carcinoma arising at the buccal mucosa: a case report and review of the literature. Cranio 2014; 33:42-5. [PMID: 25547144 DOI: 10.1179/0886963413z.00000000026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
AIMS Spindle cell carcinoma (SPCC) is a subtype of squamous cell carcinoma, and it mainly occurs in the upper aerodigestive duct. On the other hand, it rarely arises in the head and neck region. The prognosis of this tumor is usually poor because of its highly malignant behavior, such as its high incidence of recurrence or metastasis to cervical lymph nodes. However, the number of accumulated cases is still too low to provide the full details of SPCC. METHODOLOGY The case of SPCC was counted by using database, PubMed. The authors also present a case of SPCC arising at the left buccal mucosa in a 72-year-old Japanese female in the current study. RESULTS Only six cases of SPCC arising at the buccal mucosa have been reported previously. The authors' patient died from a recurrent tumor 15 months after the first operation. CONCLUSION The authors have added this case to the previous knowledge of SPCC arising at the buccal mucosa, and discuss the clinical behavior of SPCC to help suggest a standard treatment strategy for the disease.
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Dalal AJ, McLennan AS. Cervical metastases from maxillary squamous cell carcinoma: retrospective analysis and review of the literature. Br J Oral Maxillofac Surg 2013; 51:702-6. [DOI: 10.1016/j.bjoms.2013.08.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2013] [Accepted: 08/18/2013] [Indexed: 10/26/2022]
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Elective neck dissection versus observation for cN0 neck of squamous cell carcinoma primarily located in the maxillary gingiva and alveolar ridge: a retrospective study of 129 cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:556-61. [DOI: 10.1016/j.oooo.2013.07.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 06/19/2013] [Accepted: 07/16/2013] [Indexed: 02/06/2023]
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Aydil U, Kızıl Y, Bakkal FK, Köybaşıoğlu A, Uslu S. Neoplasms of the hard palate. J Oral Maxillofac Surg 2013; 72:619-26. [PMID: 24139293 DOI: 10.1016/j.joms.2013.08.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 08/11/2013] [Accepted: 08/16/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE Although the most common neoplastic lesion of the oral cavity is squamous cell carcinoma (SCC), primary neoplastic lesions of the hard palate have not been systematically reviewed to date. The aim of this study was to determine the histopathologic composition and characteristics of neoplasms of the hard palate. MATERIALS AND METHODS A retrospective analysis of 66 patients with a primary neoplasm of the hard palate managed at the authors' institution from 1985 through 2012 was performed. Demographic features, malignancy rate, histopathologic characteristics and distribution, TNM staging results, metastasis patterns, and management strategies were investigated. RESULTS The sample was composed of 66 patients (mean age, 45.0 yr; 57.6% men). Neoplasms were benign in 57.6% of cases and malignant in 42.4%. Epithelial neoplasms and mesenchymal neoplasms were encountered in 52 patients (78.8%) and 14 patients (21.2%), respectively. Minor salivary gland tumors (MSGTs) were the most common histopathologic group (60.6%), followed by benign mesenchymal tumors (15.2%), SCCs (12.1%), malignant melanomas (6.1%), lymphomas (3.0%), and sarcomas (3.0%). Although 75.0% of malignant epithelial neoplasms were at an advanced stage, there were no pN+ SCC or malignant MSGT cases at presentation. CONCLUSION The most common neoplasms of the hard palate were MSGTs. SCCs were relatively rare in this series. Although three-fourths of neoplasms were at an advanced stage, neck metastasis was not a characteristic of malignant epithelial neoplasms located in the hard palate.
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Affiliation(s)
- Utku Aydil
- Associate Professor, Department of Otorhinolaryngology, Head and Neck Surgery, Gazi University, School of Medicine, Ankara, Turkey.
| | - Yusuf Kızıl
- Associate Professor, Department of Otorhinolaryngology, Head and Neck Surgery, Gazi University, School of Medicine, Ankara, Turkey
| | - Faruk Kadri Bakkal
- Chief Resident, Department of Otorhinolaryngology, Head and Neck Surgery, Gazi University, School of Medicine, Ankara, Turkey
| | - Ahmet Köybaşıoğlu
- Professor, Department of Otorhinolaryngology, Head and Neck Surgery, Gazi University, School of Medicine, Ankara, Turkey
| | - Sabri Uslu
- Professor, Department of Otorhinolaryngology, Head and Neck Surgery, Gazi University, School of Medicine, Ankara, Turkey
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Yang Z, Deng R, Sun G, Huang X, Tang E. Cervical metastases from squamous cell carcinoma of hard palate and maxillary alveolus: A retrospective study of 10 years. Head Neck 2013; 36:969-75. [PMID: 23733304 DOI: 10.1002/hed.23398] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 01/05/2013] [Accepted: 05/23/2013] [Indexed: 12/27/2022] Open
Affiliation(s)
- Zinan Yang
- Department of Oral and Maxillofacial Surgery; Stomatological Hospital Affiliated Medical School; Nanjing University; Nanjing Jiangsu province People's Republic of China
- Department of Oral and Maxillofacial Surgery; Hospital of Stomatology, Guangzhou Medical University; Guangzhou Guangdong province People's Republic of China
| | - Runzhi Deng
- Department of Oral and Maxillofacial Surgery; Stomatological Hospital Affiliated Medical School; Nanjing University; Nanjing Jiangsu province People's Republic of China
| | - Guowen Sun
- Department of Oral and Maxillofacial Surgery; Stomatological Hospital Affiliated Medical School; Nanjing University; Nanjing Jiangsu province People's Republic of China
| | - Xiaofeng Huang
- Department of Oral and Maxillofacial Surgery; Stomatological Hospital Affiliated Medical School; Nanjing University; Nanjing Jiangsu province People's Republic of China
| | - Enyi Tang
- Department of Oral and Maxillofacial Surgery; Stomatological Hospital Affiliated Medical School; Nanjing University; Nanjing Jiangsu province People's Republic of China
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Sagheb K, Sagheb K, Taylor KJ, Al-Nawas B, Walter C. Cervical metastases of squamous cell carcinoma of the maxilla: a retrospective study of 25 years. Clin Oral Investig 2013; 18:1221-1227. [PMID: 23934238 DOI: 10.1007/s00784-013-1070-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 07/22/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Squamous cell carcinomas (SCCs) of the maxilla are relatively rare; therefore, only little data is available regarding the frequency of cervical metastasis (CM) and therapy strategies. Most authors only undertake clinical observation of the lymph nodes. The aim of this retrospective study was to evaluate the manner of metastasis in SCC of the maxilla. MATERIALS AND METHODS All patient records from 1987 to 2011 were scanned for SCC of the maxilla. Patients with SCC limited to the maxilla were comprised. The cases were analyzed regarding tumor node metastasis staging system and any special occurrences in the follow-up time such as tumor recurrence, metastasis, and exitus letalis. Classification and staging were performed according to the 2003 UICC system. RESULTS One hundred thirty-eight patients were comprised of 36 % females and 64 % males (average age, 66 years; women, 71 years; men, 63 years). The average follow-up time was 43 months (range, 0-195). Fifty-eight percent smoked or declared regular consumption of alcohol. About 50 % of the patients had an advanced tumor stage (III-IV). At the time of the primary diagnosis, 38 % of the patients had CM. There is an increased risk for CM occurrence with increasing tumor size and grading and a tumor localized in the postcanine region. Contralateral CM arises frequently in T4 tumors and tumors localized in the postcanine region. CONCLUSION The data exhibit aggressive regional metastatic behavior of SCC of the maxilla. CLINICAL RELEVANCE Therefore, surgical treatment of the draining lymphatic system as a primary management strategy is recommended for patients with SCC of the maxilla.
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Affiliation(s)
- K Sagheb
- Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg-University of Mainz, Augustusplatz 2, 55131, Mainz, Germany.
| | - Ka Sagheb
- Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg-University of Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - K J Taylor
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg-University of Mainz, Obere Zahlbacher Str. 69, 55131, Mainz, Germany
| | - B Al-Nawas
- Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg-University of Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - C Walter
- Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg-University of Mainz, Augustusplatz 2, 55131, Mainz, Germany
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MRI pre-treatment tumour volume in maxillary complex squamous cell carcinoma treated with surgical resection. J Craniomaxillofac Surg 2013; 42:119-24. [PMID: 23777920 DOI: 10.1016/j.jcms.2013.03.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Revised: 03/22/2013] [Accepted: 03/25/2013] [Indexed: 11/22/2022] Open
Abstract
UNLABELLED Tumour volume (Tv) measurements obtained from pre-treatment CT and MRI have increasingly shown to be more reliable predictors of outcome than TNM stage. The aim of this study was to determine the correlation of MRI calculated maxillary complex tumour volume with patient outcome. METHODS The medical records of 39 patients with squamous cell carcinoma involving the maxillary sinus, maxilla, hard palate and maxillary alveolus were reviewed and tumour volume measurements completed on pre-treatment MRI. RESULTS The mean tumour volume was 12.79 ± 24.31 cm(3). Independent samples t test was significant for increasing overall all-cause survival and decreasing tumour volume (1 year: p = 0.003; 5-year: p = 0.031). Cox regression was significant for stratified tumour volume, nodal involvement and peri-neural invasion for predicting disease-free survival. CONCLUSIONS MRI measured tumour volume assessment appears to be a reliable predictor of survival in patients with maxillary complex SCC treated by surgical resection.
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Meng FY, Ko JY, Lou PJ, Wang CP, Yang TL, Chang CH, Chang YL, Chen TC. The determining risk factors for treatment outcomes in patients with squamous cell carcinoma of the hard palate. Ann Surg Oncol 2012; 19:2003-10. [PMID: 22271207 DOI: 10.1245/s10434-011-2214-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Indexed: 11/18/2022]
Abstract
BACKGROUND The determining risk factors for patients with squamous cell carcinoma of the hard palate are not well verified. METHODS Medical records from our facility of all patients with squamous cell carcinoma of the hard palate receiving curative surgery between March 2003 and May 2009 were reviewed. RESULTS Seventy-eight patients were enrolled in the study. The 5 year disease-free and overall survival rates were 49.8 and 49.7%, respectively. The 5 year disease-free and overall survival rates were statistically different between positive/close margins and negative margins (24.6% vs. 65.4%, P = 0.02; 20.1% vs. 63.1%, P = 0.001, respectively), with and without soft palate invasion (38.8% vs. 68.9%, P = 0.02; 27.4% vs. 77.5%, P = 0.001, respectively), and soft palate invasion patients with and without perineural invasion (10.4% vs. 52.8%, P = 0.02; 0% vs. 38.1%, P = 0.008, respectively). The rate of positive nodal metastasis for T3 and T4 tumors was 44%. For the tumor with soft palate invasion, the rate of positive nodal metastasis was 29%. After multivariate analyses, soft palate invasion and positive/close margins were the determining risk factors for disease-free and overall survival. CONCLUSIONS Soft palate invasion and positive/close margins were the determining risk factors for disease-free and overall survival in patients with squamous cell carcinoma of the hard palate. Elective neck dissection is suggested for advanced primary tumors (T3 or T4) or tumors with soft palate invasion.
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Affiliation(s)
- Fan-Yu Meng
- Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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