Cervical metastasis of maxillary squamous cell carcinoma

A retrospective study of maxillary squamous cell carcinoma (SCC) patients attending a department of oral and maxillofacial surgery was performed for the period 2000-2010. The clinical information of 100 cases treated during this period was acquired and analyzed. Patient survival was calculated using the Kaplan-Meier method. For these 100 cases, the total metastatic rate was 34.0% and occult metastatic rate was 27.5%. Positive lymph nodes were mostly detected at levels I-III. There was no significant difference in metastatic rate between the primary sites of maxillary gingiva and hard palate. Tumours involving the gingival-buccal sulcus presented a significantly higher risk of metastasis. Advanced stage (T3/4) was significantly correlated with a higher metastasis rate. The pathological grade also showed a significant relationship with metastasis. Twenty-four patients presented regional recurrence. Elective neck dissection could significantly reduce the recurrence rate. The overall 3-year and 5-year survival rates were 66.3% and 56.7%, respectively. Both the T and the N stages had a significant impact on survival rates. Selective neck dissection from level I to III is recommended for T3/4 stage cN0 patients, especially those with gingival-buccal sulcus involvement.