KUMJ | VOL. 22 | NO. 1 | ISSUE 85 | JANUARY - MARCH
Is an Elective Neck Dissection Needed in Squamous Cell Carcinoma of the Maxillary Alveolus and Hard Palate?
Bhandari S, Michael RC, Riju J, Thomas M, Irodi A, Rani J, Tirkey AJ, Vidya K, Mathew SS, Madhavi K
Abstract: Background
Squamous cell carcinoma (SCC) of the maxillary alveolus and hard palate is a rare site
for oral cavity carcinoma. Much controversy is there regarding the management of
this site and elective neck dissection due to rarity and complex lymphatic drainage.
Objective
To estimate the prevalence of neck nodal metastasis in squamous cell carcinoma of
maxillary alveolus and hard palate and the factors influencing the nodal metastasis.
Method
This retrospective cohort study includes patients diagnosed with squamous cell
carcinoma of maxillary alveolus and hard palate and who underwent surgical
intervention between March 2017 and March 2022.
Result
The study included 53 patients among them majority were men (73.6%). Prevalence
of neck nodal metastasis was 36.6% and occult nodal metastasis was noted in 16%.
On multivariate analysis, clinical nodal positivity increases the odds of pathological
nodal positivity by 9.4 times compared to no nodal involvement (95% CI 2.07–42.57,
p < 0.004). A depth of invasion (DOI) of more than 10 mm increases risk by 7.4 times
for pathological nodal positivity compared to less than 10 mm invasion (95% CI 1.53–
35.27, p=0.013).
Conclusion
Squamous cell carcinoma of maxillary alveolus and hard palate has a high risk of nodal
metastasis. Depth of invasion is an important predictor for nodal metastasis. Due to
the high risk of nodal metastasis elective neck dissection would be recommended
in advanced stages. Squamous cell carcinoma of maxillary alveolus and hard palate
with nodal metastasis has a poor survival.
Keyword : Hard palate, Lymph node metastasis, Neck dissections, Squamous cell carcinoma
