PURPOSE OF REVIEW: To discuss and review the role for elective treatment of the neck in maxillary squamous cell carcinoma. Improvements in survival have been seen because of improved local therapies and control; therefore, the treatment of the neck has become a topic of debate. RECENT FINDINGS: The risk of occult metastases in neck nodes is higher for T3-4 tumors. The rate of nodal relapse in the N0 neck without elective treatment is 8-15%. With elective irradiation the nodal relapse rate decreases. However, most nodal relapses are accompanied by local failure or distant disease. Local failure remains the most common site of failure and cause of death in this patient population. SUMMARY: Treatment failure occurs overall in 62% of all patients, with local recurrence by far the most common site of treatment failure, which is rarely amenable to salvage therapy. Therefore, elective neck irradiation is not routinely indicated in the clinically N0 neck; those that recur only in the neck can be surgically salvaged more than 50% of the time.
PURPOSE OF REVIEW: To discuss and review the role for elective treatment of the neck in maxillary squamous cell carcinoma. Improvements in survival have been seen because of improved local therapies and control; therefore, the treatment of the neck has become a topic of debate. RECENT FINDINGS: The risk of occult metastases in neck nodes is higher for T3-4 tumors. The rate of nodal relapse in the N0 neck without elective treatment is 8-15%. With elective irradiation the nodal relapse rate decreases. However, most nodal relapses are accompanied by local failure or distant disease. Local failure remains the most common site of failure and cause of death in this patient population. SUMMARY: Treatment failure occurs overall in 62% of all patients, with local recurrence by far the most common site of treatment failure, which is rarely amenable to salvage therapy. Therefore, elective neck irradiation is not routinely indicated in the clinically N0 neck; those that recur only in the neck can be surgically salvaged more than 50% of the time.
Authors: Valentino Valentini; Valentina Terenzi; Andrea Battisti; Andrea Cassoni; Andrea Anelli; Paolo Priore; Paolo Petrinca Journal: J Craniofac Surg Date: 2010-05 Impact factor: 1.046
Authors: Anne Marijn Kreeft; Ludwig E Smeele; Coen R N Rasch; Michael Hauptmann; Derk H F Rietveld; C René Leemans; Alfons J M Balm Journal: Head Neck Date: 2012-01-17 Impact factor: 3.147
Authors: Piet Dirix; Sandra Nuyts; Yasmyne Geussens; Mark Jorissen; Vincent Vander Poorten; Eric Fossion; Robert Hermans; Walter Van den Bogaert Journal: Int J Radiat Oncol Biol Phys Date: 2007-06-14 Impact factor: 7.038
Authors: Robert P Takes; Alfio Ferlito; Carl E Silver; Alessandra Rinaldo; Jesus E Medina; K Thomas Robbins; Juan P Rodrigo; Marc Hamoir; Carlos Suárez; Peter Zbären; Vanni Mondin; Ashok R Shaha; William M Mendenhall; Primož Strojan Journal: Eur Arch Otorhinolaryngol Date: 2013-06-20 Impact factor: 2.503