The role of elective neck dissection in the treatment of maxillary sinus squamous cell carcinoma.

The role of elective neck dissection in the treatment of maxillary sinus squamous cell carcinoma.

Laryngoscope. 2017 Nov 29;:

Authors: Sangal NR, Lee YJ, Brady JS, Patel TD, Eloy JA, Baredes S, Park RCW

Abstract
OBJECTIVE: This study is designed to analyze the survival benefits of elective neck dissection (END) in the treatment of squamous cell carcinoma of the maxillary sinus (MS-SCC) with clinically negative neck lymph nodes (N0) and no metastasis (M0).
STUDY DESIGN: The aim of this study was to evaluate whether END improves survival in patients with MS-SCC.
METHODS: This study is a population-based, concurrent retrospective database analysis of patients diagnosed with N0M0 MS-SCC from 2004 to 2013. Data were acquired from the Surveillance, Epidemiology, and End Results database. Frequency functions, Kaplan-Meier and Cox regression models were queried to analyze demographics, treatment status, and survival outcomes.
RESULTS: There were a total of 927 MS-SCC cases in the database between 2004 and 2013. This analysis revealed that for the overall cohort, END significantly and independently reduces the 5-year hazard of death in MS-SCC (hazard ratio [HR] = 0.646, 95% confidence interval [CI] = 0.419-0.873, P = 0.047). For early tumor (T)1/T2 tumors and T4 tumors, END did not independently improve 5-year survival. However, for T3 disease, END significantly reduced the 5-year hazard of death in MS-SCC (HR = 0.471, 95% CI = 0.261-0.680, P = 0.001), regardless of other covariates, including adjuvant radiation. There has been an increase in the percentage of MS-SCC surgeries that have been accompanied by END since SEER started collecting this data, although this did not demonstrate significance (R2 = 0.622).
CONCLUSION: END improves disease-specific survival in patients with MS-SCC size > 4 cm and advanced T-stage (American Joint Committee on Cancer AJCC TIII). Therefore, surgeons performing maxillectomies should consider conducting an END concurrent with maxillectomy for those with size > 4 cm advanced stage cancer.
LEVEL OF EVIDENCE: 4. Laryngoscope, 2017.

PMID: 29193120 [PubMed - as supplied by publisher]

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