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


Journal of Medical Diagnostic Methods

Author(s): Lin HW, Bhattacharyya N

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Abstract 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. This article was published in Laryngoscope and referenced in Journal of Medical Diagnostic Methods

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