Squamous cell carcinoma of the maxillary gingiva, alveolus, and hard palate: is there a need for elective neck dissection?

We retrospectively studied 17 patients with squamous cell carcinoma (SCC) of the maxillary gingiva, alveolus, and hard palate who were treated over a 7-year period (2000-2007) to investigate whether selective neck dissection is justified at an early stage. Four patients presented with metastases in the neck, and all developed early recurrence in the neck, with poor prognosis. Of the 13 patients who initially had no sign of metastases, two developed regional metastases within the first 18 months of initial treatment. Squamous cancers of the maxillary gingiva, alveolus, and hard palate should be treated aggressively, and elective neck dissection should be considered because of the high risk of occult metastases. Prospective studies are difficult because of the rarity of the tumour. (C) 2009 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.