Clinical Research Of The Incidence Of Cervical Metastasis And The Management Of Neck In Oral Maxillary Squamous Cell Carcinoma

Objective: To investigate the incidence of cervical metastasis and the influencingfactors relative to oral maxillary squamous cell carcinoma，and to explore appropriatetherapies.Methods: A total of63cases with squamous cell carcinomas of the hard palate,maxillary gingiva, and maxillary alveolus from January2000to July2011werereviewed retrospectively. To analyze the incidence of cervical metastasis in thepatients with oral maxillary squamous cell carcinoma presenting for initialconsultation, and the incidence of cervical metastasis of the cN0patients after ablativesurgery. Clinical and pathological characeristics were assessed.Results: Cervical disease was detected in14.29%of those individuals with maxillarysquamous cell carcinoma presenting for initial consultation. After ablative surgery, thecN0patients had a16.00%rate of regional node metastasis. The rate of lymph nodemetastasis was24.24%in cN0patients which lesions involving the muscle andbones.Clinical stage and depth of invasion were risk factors for lymph nodemetastasis according to univariate analysis．Significant predictors of lymph nodemetastasis in both univariate and multivariate analysis was depth of invasion.Conclusions: The rate of cervical metastasis of oral maxillary squamous cellcarcinoma was low. The rate of cervical metastasis of cN0patients which lesionsinvolving the muscle and bones patients（T4）was high.Based on the cases that wereviewed,we recommend selective neck dissection in the setting of a clinicallynegative neck should be a primary management strategy for patients which lesionsinvolving the muscle and bones. The depth of invasion is important risk factor forlymph node metastasis in oral maxillary squamous cell carcinoma．...