Maxillary squamous cell carcinoma: an 11-year retrospective study of one regional cancer centre

Intraoral maxillary squamous cell carcinoma (IOMSCC) tumours are comparatively rare compared to those occurring at other oral sites. This has resulted in limited studies regarding their pattern of local and regional behaviour. In a review of the IOMSCC cohort (N=39) at the study institution, IOMSCC was found to demonstrate a pattern of levels 1-3 nodal disease in the N+ neck at presentation (33.3%), with a total metastatic rate of 46.1%, which is similar to that for other intraoral sites. IOMSCC demonstrated metastatic potential to the contralateral neck, with 20% of patients progressing to present with disease. This seems to occur irrespective of midline involvement. On observation of the N0 group patients who did not have surgical treatment of the neck, the rate of progression to disease development was similar to those with N+ necks on presentation (38.5%). An ipsilateral selective neck dissection in the N0 cohort appeared to have resolved ipsilateral neck disease, but the disease rate in the contralateral neck, although numbers are small, was >20%. This clinical review suggests the use of level 1-3 ipsilateral neck dissection in treating the N0 patient for IOMSCC and may indicate a role for sentinel node biopsy in the management of the contralateral neck.