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Lymph Node Metastasis in T4 Maxillary Sinus Squamous Cell Carcinoma: Incidence and Treatment Outcome
Authors:Akihiro Homma MD  Ryuichi Hayashi MD  Kazuto Matsuura MD  Kengo Kato MD  Kazuyoshi Kawabata MD  Nobuya Monden MD  Yasuhisa Hasegawa MD  Tetsuro Onitsuka MD  Yasushi Fujimoto MD  Shigemichi Iwae MD  Kenji Okami MD  Takashi Matsuzuka MD  Kunitoshi Yoshino MD  Ken-ichi Nibu MD  Takakuni Kato MD  Hiroshi Nishino MD  Takahiro Asakage MD  Ichiro Ota MD  Morimasa Kitamura MD  Akira Kubota MD  Tsutomu Ueda MD  Kaichiro Ikebuchi MD  Akihito Watanabe MD  Masato Fujii MD
Affiliation:1. Department of Otolaryngology – Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
2. Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
3. Head and Neck Surgery, Miyagi Cancer Center, Sendai, Japan
4. Otolaryngology-Head and Neck Surgery, Tohoku University School of Medicine, Sendai, Japan
5. Head and Neck Oncology, Japanese Foundation for Cancer Research, Cancer Institute Hospital, Tokyo, Japan
6. Otorhinolaryngology-Head and Neck Surgery, National Shikoku Cancer Center, Matsuyama, Matsuyama, Japan
7. Head and Neck Surgery, Aichi Cancer Center, Nagoya, Japan
8. Head and Neck Surgery, Shizuoka Cancer Center, Shizuoka, Japan
9. Otolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
10. Head and Neck Surgery, Hyogo Cancer Center, Akashi, Japan
11. Otolaryngology, Tokai University School of Medicine, Isehara, Japan
12. Otolaryngology, Fukushima Medical University School of Medicine, Fukushima, Japan
13. Otolaryngology-Head and Neck Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
14. Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
15. Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
16. Otolaryngology-Head and Neck Surgery, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
17. Otolaryngology-Head and Neck Surgery, Tokyo University School of Medicine, Tokyo, Japan
18. Otolaryngology-Head and Neck Surgery, Nara Medical University, Nara, Japan
19. Otolaryngology-Head and Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
20. Head and Neck Surgery, Kanagawa Cancer Center, Yokohama, Japan
21. Otolaryngology, Hiroshima University School of Medicine, Hiroshima, Japan
22. Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
23. Otolaryngology, Keiyukai Sapporo Hospital, Sapporo, Japan
24. Otorhinolaryngology, National Tokyo Medical Center, Tokyo, Japan
Abstract:

Background

The purpose of this study was to evaluate the incidence of lymph node metastasis among patients with T4 maxillary sinus squamous cell carcinoma (MS-SCC) as well as the delayed metastasis rate and the treatment outcome for untreated N0 neck in patients with T4 MS-SCC.

Methods

Consecutive series of all patients (n = 128) with previously untreated T4 maxillary sinus SCC between 2006 and 2007 were obtained from 28 institutions belonging to or cooperating in the Head and Neck Cancer Study Group of the Japan Clinical Oncology Group.

Results

Of the 128 patients, 28 (21.9 %) had lymph node metastasis, and six patients (4.7 %) had distant metastasis at diagnosis. Among the 111 patients who were treated with curative intent, 98 had clinically N0 neck disease and did not receive prophylactic neck irradiation. A total of 11 patients (11.2 %) subsequently developed evidence of lymph node metastasis, of whom eight were among the 83 patients with an N0 neck and had not received elective neck treatment. There were 15 patients who received an elective neck dissection as part of the initial treatment, of whom three had pathologically positive for lymph node metastases. Of 11 patients, six patients with nonlateral retropharyngeal lymph node metastasis without primary or distant disease were successfully salvaged.

Conclusions

This study identified the incidence of lymph node metastasis among patients with T4 MS-SCC as well as the delayed metastasis rate and the treatment outcome for untreated N0 neck in patients with T4 MS-SCC. These results will be of assistance in selecting treatment strategy for T4 MS-SCC in the future.
Keywords:
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