Sagheb K, Sagheb Ka, Taylor K J, Al-Nawas B, Walter C
Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg-University of Mainz, Augustusplatz 2, 55131, Mainz, Germany.
Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg-University of Mainz, Obere Zahlbacher Str. 69, 55131, Mainz, Germany.
Clin Oral Investig. 2014 May;18(4):1221-1227. doi: 10.1007/s00784-013-1070-8. Epub 2013 Aug 11.
Squamous cell carcinomas (SCCs) of the maxilla are relatively rare; therefore, only little data is available regarding the frequency of cervical metastasis (CM) and therapy strategies. Most authors only undertake clinical observation of the lymph nodes. The aim of this retrospective study was to evaluate the manner of metastasis in SCC of the maxilla.
All patient records from 1987 to 2011 were scanned for SCC of the maxilla. Patients with SCC limited to the maxilla were comprised. The cases were analyzed regarding tumor node metastasis staging system and any special occurrences in the follow-up time such as tumor recurrence, metastasis, and exitus letalis. Classification and staging were performed according to the 2003 UICC system.
One hundred thirty-eight patients were comprised of 36 % females and 64 % males (average age, 66 years; women, 71 years; men, 63 years). The average follow-up time was 43 months (range, 0-195). Fifty-eight percent smoked or declared regular consumption of alcohol. About 50 % of the patients had an advanced tumor stage (III-IV). At the time of the primary diagnosis, 38 % of the patients had CM. There is an increased risk for CM occurrence with increasing tumor size and grading and a tumor localized in the postcanine region. Contralateral CM arises frequently in T4 tumors and tumors localized in the postcanine region.
The data exhibit aggressive regional metastatic behavior of SCC of the maxilla.
Therefore, surgical treatment of the draining lymphatic system as a primary management strategy is recommended for patients with SCC of the maxilla.
上颌骨鳞状细胞癌（SCC）相对罕见；因此，关于颈部转移（CM）频率和治疗策略的数据很少。大多数作者仅对淋巴结进行临床观察。这项回顾性研究的目的是评估上颌骨SCC的转移方式。
扫描1987年至2011年所有患者记录，查找上颌骨SCC患者。纳入上颌骨局限性SCC患者。分析病例的肿瘤淋巴结转移分期系统以及随访期间的任何特殊情况，如肿瘤复发、转移和死亡。根据2003年UICC系统进行分类和分期。
138例患者中，女性占36%，男性占64%（平均年龄66岁；女性71岁，男性63岁）。平均随访时间为43个月（范围0 - 195个月）。58%的患者吸烟或宣称经常饮酒。约50%的患者肿瘤分期较晚（III - IV期）。初诊时，38%的患者有CM。随着肿瘤大小和分级增加以及肿瘤位于犬齿后区域，CM发生风险增加。对侧CM在T4肿瘤和位于犬齿后区域的肿瘤中频繁出现。
数据显示上颌骨SCC具有侵袭性的区域转移行为。
因此，对于上颌骨SCC患者，建议将引流淋巴系统的手术治疗作为主要治疗策略。
