Clinical course and survival in patients with squamous cell carcinoma of the maxillary alveolus and hard palate: Results from a single-center prospective cohort.

Objectives: Operative management of squamous cell carcinoma of the maxillary alveolus and hard palate (MHSCC) is still a controversial issue, especially for cN0 cases. We report the survival outcomes in patients with MHSCC, including the rate of cervical occult metastasis for UICC stages I/II and survival after elective neck dissection (END).

Methods: 77 patients with primary MHSCC were followed-up from 2 months to 14.6 years within a prospectively obtained patient cohort. Factors influencing overall survival (OS), oral cancer-specific survival (OCSS) and disease-free survival (DFS) were assessed. We estimated survival probabilities using Kaplan-Meier survival analysis by histology and stage. We used Cox's proportional hazard regression model to estimate adjusted hazard ratios for OS, OCSS and DFS.

Results: Initially, 22 patients presented with stage I, 13 with stage 2, 11 patients with stage 3 and 31 with stage 4 tumors. The presence of nodal disease rose with increased tumor size. 66.2% were treated with surgery only, 26.0% received adjuvant radiotherapy, and 7.8% received primary radiotherapy. Median overall survival was 10.9 years, and survival probabilities at 2, 5 and 10 years were 68.2%, 61.1% and 61.1%, respectively. Five-year overall survival was 72.4% in the END group and 88.9% in the non-END group. Factors influencing OS, OCSS and DFS were tumor size, the presence of metastatic disease and positive resection margins.

Conclusions: MHSCC seems to show a better overall survival compared to OSCC of other locations and is less likely to develop regional and distant metastasis; END might not be necessary in early stage tumors.