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Updated: May 28, 2026
Modified Radical Neck Dissection for Cervical Metastasis
Published on: February 20, 2026
Oral maxillary squamous carcinoma: an indication for neck dissection in the clinically negative neck
David M Montes1, Eric R Carlson, Rui Fernandes
1Department of Oral and Maxillofacial Surgery, Sanford-MeritCare Health System, Fargo, North Dakota, USA.
Background:
This multicenter study was undertaken to characterize the metastatic behavior of oral maxillary squamous carcinoma and to determine the role of selective neck dissection.
Methods:
A retrospective, multicenter study of patients surgically treated for oral maxillary squamous carcinoma was completed. Data collected included primary tumor location, cervical lymph node status, and neck failure rate.
Results:
The study included 146 patients. The adjusted regional metastatic rate was 31.4%. Of those N0 (clinically negative) necks treated with or without neck dissection, 14.4% developed cervical metastasis. Within the cohort, 7.5% of patients died with distant disease. The regional salvage rate was 52.9%. None of the patients with locoregional failures were salvaged.
Conclusions:
Maxillary palatal, alveolar, and gingival squamous carcinomas exhibit aggressive regional metastatic behavior. Surgical salvage rates for neck failure are low; therefore, selective neck dissection (levels I-III) is recommended at the time of resection of T2, T3, and T4 maxillary squamous carcinomas.