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Table 1: Studies included in the review about patients with squamous cell carcinoma of the upper maxilla
Author Year Country No. of Study Nodal Initial Overal Follow-up
patients disease in nodal nodal (months)
T3/T4 (%) disease disease
(%) incidence
(%)
Truitt et al. [23] 1999 USA 24 Retrospective Unknown 17% 33% 60
Ogura et al. [14] 2003 Japan 21 Retrospective Unknown 29% 67% Unknown
Simental et al. [11] 2006 USA 26 Retrospective Unknown 12% 35% 65
Zwetyenga et al. [35] 2006 France 34 Retrospective 91% 18% 32% Unknown
Montes and Schmid [9] 2008 USA 14 Retrospective 50% 21% 43% 27

Lin and Bhattacharyya [22] 2009 USA 725 Cross-section 64% 14% 14% Unknown
Kruse and Grätz [12] 2009 Switzerland 30 Retrospective 18% 13% 37% Unknown
Mourouzis et al. [13] 2010 UK 17 Retrospective 100% 24% 35% 60
Montes et al. [16] 2011 USA 131 Retrospective 55% 24% 31% 1-180
Lubek et al. [18] 2011 USA 37 Retrospective 67% 5% 16% 49
Nicolai et al. [34] 2010 Italy 86 Retrospective 31% 9% 22% Unknown
Wang et al. [36] 2010 Taiwan 79 Retrospective 100% 9% 22% Unknown
Valentini et al. [25] 2010 Italy 19 Retrospective Unknown 5% 11% Unknown
Beltramini et al. [26] 2012 Italy 65 Retrospective 86% 12% 22% 43.3
Morris et al. [15] 2011 USA 139 Retrospective 71% 8% 31% 57
Brown et al. [10] 2013 UK 43 Retrospective 81% 7% 37% 94
Poeschl et al. [33] 2012 Austria 74 Retrospective 100% Unknown 22% 6-130
Dalal and McLennan [30] 2013 UK 30 Retrospective 100% 27% 36% 60
Feng et al. [27] 2013 China 129 Retrospective 65% 0% 24% Unknown
Eskander et al. [32] 2013 Canada 97 Cohort 53% 24% 41% Unknown
Sagheb et al. [29] 2014 Germany 138 Retrospective 60% 38% 46% 43
Zhang et al. [37] 2015 China 100 Retrospective 79% 9% 34% 46
Philip et al. [24] 2014 UK 39 Retrospective 95% 33% 46% 38
Givi et al. [39] 2016 USA 199 Retrospective 50% 6% 22% 52
Berger et al. [40] 2015 Germany 171 Retrospective 78% Unknown 44% Unknown
Yang et al. [28] 2015 China 62 Retrospective 69% 15% 37% 37
Troeltzsch et al. [41] 2016 Germany 92 Retrospective 40% 16% 29% 42
Moreno-Sánchez et al. [42] 2016 Spain 20 Retrospective 100% 30% 45% 53

have evaluated the need for elective neck dissection in METHODS
these intraoral common sites when there is no clinical or
radiographic suspicious of lymphadenopathy. [6-10] Controversies An electronic literature search was conducted in several
remain regarding the strategy of treatment for patients databases, including MEDLINE, EMBASE, and Cochrane
with maxillary SCC, [11-15] including indications for Central databases, for articles written in English from
unilateral or bilateral elective neck dissection and their respective dates of inception to December 2015.
postoperative adjuvant treatment. [16-20] Only a few The searching keywords were “cervical metastases”
authors [21-25] have focused on the management of the OR “cervical metastases” OR “neck metastases” AND
neck in SCC of the maxillary gingiva, maxillary alveolus “maxillary squamous cell carcinoma” OR “maxilla
and hard palate. [26-30] squamous cell carcinoma” OR “squamous cell carcinoma
of upper maxilla” AND (limit to clinical trial OR
Traditionally, when there is no clinical or radiographic randomized controlled trial).
suspicious of lymphadenopathy, management has been
to watch and wait. However, in recent studies, [31-35] it The abstracts of yielded results were reviewed and the
has been proven that a higher rate of occult cervical full text of those with apparent relevance was obtained.
metastases in SCC of the maxilla has been found [36-40] The references of identified articles were crosschecked
and elective neck dissection in these patients has been for unidentified articles. These journals were Journal of
recommended in order to reduce recurrences. [41-43] Oral and Maxillofacial Surgery; International Journal of Oral
and Maxillofacial Surgery; Journal of Oral Surgery; British
A systematic review was conducted in order to clarify if Journal of Oral and Maxillofacial Surgery; Head and Neck
elective neck dissection is necessary in management of Surgery; Laryngoscope; Oral Oncology; Journal of Cranio-
SCC of the maxillary gingiva, maxillary alveolus and hard Maxillo-Facial Surgery; Oral Surgery, Oral Medicine, Oral
palate, and to identify the risk of cervical metastases in Pathology and Oral Radiology; and Revista Española de Cirugía
patients with maxillary SCC. Oral y Maxilofacial. The searches were limited to articles
176 Plast Aesthet Res || Volume 3 || June 24, 2016