Cervical metastases of oral maxillary squamous cell carcinoma: A systematic review and meta-analysis

Head Neck. 2016 Apr:38 Suppl 1:E2335-42. doi: 10.1002/hed.24274. Epub 2016 Feb 18.

Abstract

Cervical treatment of oral maxillary squamous cell carcinoma (SCC) remains controversial. We determined the metastases incidence and evaluated its predictive factors. Systematic review and meta-analysis was conducted of 23 Chinese and English-language articles retrieved from PubMed, Ovid, Embase, Cochrane Library, China National Knowledge Infrastructure, and Chinese Scientific and Technological Journal databases. Total cervical metastases and occult metastases rate was 32% and 21%, respectively. Positive lymph node detection was likeliest from levels I to III. The maxillary gingival metastases rate was higher than that of the hard palate. Advanced-stage tumors had higher metastatic risk than early-stage tumors. Well-differentiated tumors had a significantly higher metastases rate than medium and poor-differentiation tumors. N0 cases had survival benefit compared with N+ cases. Metastases rate of oral maxillary SCC correlates significantly with T classification and pathological stage. T and N classifications impact outcome significantly. Therefore, levels I to III selective neck dissection is recommended for patients with T3/4 cN0 disease. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2335-E2342, 2016.

Keywords: cervical metastases; elective neck dissection; hard palate; maxillary gingiva; squamous cell carcinoma.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / surgery
  • China
  • Female
  • Humans
  • Lymphatic Metastasis / diagnosis*
  • Maxillary Neoplasms / secondary
  • Mouth Neoplasms / pathology*
  • Neck Dissection
  • Neoplasm Staging
  • Palate, Hard / pathology