Is elective neck dissection needed in squamous cell carcinoma of maxilla?
박중현, 남웅, 김형준, 차인호,
소속 상세정보
박중현 ( Park Jung-Hyun ) - Yonsei University College of Dentistry Department of Oral and Maxillofacial Surgery
남웅 ( Nam Woong ) - Yonsei University College of Dentistry Department of Oral and Maxillofacial Surgery
김형준 ( Kim Hyung-Jun ) - Yonsei University College of Dentistry Department of Oral and Maxillofacial Surgery
차인호 ( Cha In-Ho ) - Yonsei University College of Dentistry Department of Oral and Maxillofacial Surgery
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.
키워드
Occult cervical metastasis; Squamous cell carcinoma; Maxillary gingiva; Maxillary sinus; Elective neck dissection
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