Survival impact of nodal disease in hard palate and maxillary alveolus cancer.

OBJECTIVE

Evaluate the impact of primary site stage and cervical metastasis on the survival of patients with squamous cell carcinoma (SCC) of the hard palate or maxillary alveolus.

STUDY DESIGN

Cross-sectional population analysis of prospectively maintained database.

METHODS

Cases of hard palate and maxillary alveolus SCC from 1988-2004 were extracted from the Surveillance, Epidemiology, and End Results database. Demographic data and extent of disease were extracted for each case, and T-stage, and N-stage were computed. Survival differences according to T-stage and N-stage were determined with the Kaplan-Meier method and the log-rank test.

RESULTS

Four hundred eleven cases of maxillary alveolus and 314 cases of hard palate SCC were identified, for a total of 725 cases (53.9% female, mean age: 70.9 years). The prevalence of cervical metastasis was not significantly different according to primary site (P = .181); advanced N-stage significantly correlated with more advanced T-stage (P < .001). Of the 725 cases, 4.1% of T1 tumors, 14.9% of T2 tumors, 10.3% of T3 tumors, and 24.7% of T4 tumors had cervical nodal metastases. The mean overall survivals were 96.5, 69.1, 67.8, and 49.3 months for T1-T4 tumors, respectively (P < .001). With regard to N-stage, the mean survivals were 73.7, 69.7, 29.8, and 5.5 months for N0-N3 lesions, respectively (P < .001). Nodal metastasis effect on survival remained significant (P < .039) in stratified survival analysis except for T3 lesions (P = .205).

CONCLUSIONS

Survival in patients with SCC of either the hard palate or maxillary alveolus is significantly influenced by T-stage and a nonnegligible rate of cervical nodal metastases.