Annals of Surgical Oncology

, Volume 21, Issue 5, pp 1706–1710 | Cite as

Lymph Node Metastasis in T4 Maxillary Sinus Squamous Cell Carcinoma: Incidence and Treatment Outcome

  • Akihiro HommaEmail author
  • Ryuichi Hayashi
  • Kazuto Matsuura
  • Kengo Kato
  • Kazuyoshi Kawabata
  • Nobuya Monden
  • Yasuhisa Hasegawa
  • Tetsuro Onitsuka
  • Yasushi Fujimoto
  • Shigemichi Iwae
  • Kenji Okami
  • Takashi Matsuzuka
  • Kunitoshi Yoshino
  • Ken-ichi Nibu
  • Takakuni Kato
  • Hiroshi Nishino
  • Takahiro Asakage
  • Ichiro Ota
  • Morimasa Kitamura
  • Akira Kubota
  • Tsutomu Ueda
  • Kaichiro Ikebuchi
  • Akihito Watanabe
  • Masato Fujii
Head and Neck Oncology



The purpose of this study was to evaluate the incidence of lymph node metastasis among patients with T4 maxillary sinus squamous cell carcinoma (MS-SCC) as well as the delayed metastasis rate and the treatment outcome for untreated N0 neck in patients with T4 MS-SCC.


Consecutive series of all patients (n = 128) with previously untreated T4 maxillary sinus SCC between 2006 and 2007 were obtained from 28 institutions belonging to or cooperating in the Head and Neck Cancer Study Group of the Japan Clinical Oncology Group.


Of the 128 patients, 28 (21.9 %) had lymph node metastasis, and six patients (4.7 %) had distant metastasis at diagnosis. Among the 111 patients who were treated with curative intent, 98 had clinically N0 neck disease and did not receive prophylactic neck irradiation. A total of 11 patients (11.2 %) subsequently developed evidence of lymph node metastasis, of whom eight were among the 83 patients with an N0 neck and had not received elective neck treatment. There were 15 patients who received an elective neck dissection as part of the initial treatment, of whom three had pathologically positive for lymph node metastases. Of 11 patients, six patients with nonlateral retropharyngeal lymph node metastasis without primary or distant disease were successfully salvaged.


This study identified the incidence of lymph node metastasis among patients with T4 MS-SCC as well as the delayed metastasis rate and the treatment outcome for untreated N0 neck in patients with T4 MS-SCC. These results will be of assistance in selecting treatment strategy for T4 MS-SCC in the future.


Maxillary Sinus Elective Neck Dissection Neck Metastasis Japan Clinical Oncology Group Neck Lymph Node Metastasis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This study was supported in part by a Health and Labour Sciences Research Grant for Clinical Cancer Research (H22-Gannrinshou-Ippan-017) from the Ministry of Health, Labour and Welfare of Japan, the National Cancer Center Research and Development Fund (23-A-21) of Japan, and a grant-in-aid for Scientific Research (C) (KAKENHI 24592587) from the Ministry of Education, Culture, Sports, Science, and Technology of Japan. In addition to the authors, the following investigators participated in this study: National Cancer Center Hospital East, Kashiwa—T. Shinohara; Miyagi Cancer Center, Sendai—Y. Asada; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo—T. Sasaki; Aichi Cancer Center, Nagoya—H. Hirakawa; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka—T. Fujii; Kobe University Graduate School of Medicine—N. Otsuki; Tokyo University—Y. Saito; Aichi Medical University, Nagakute—A. Ikeda; Iwate Prefectural Central Hospital, Morioka—S. Kato; Kochi Health Sciences Center, Kochi—K. Kozakura; Japanese Red Cross Nagoya Daiichi Hospital, Nagoya—K. Kawata and A. Terada.


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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Akihiro Homma
    • 1
    Email author
  • Ryuichi Hayashi
    • 2
  • Kazuto Matsuura
    • 3
  • Kengo Kato
    • 4
  • Kazuyoshi Kawabata
    • 5
  • Nobuya Monden
    • 6
  • Yasuhisa Hasegawa
    • 7
  • Tetsuro Onitsuka
    • 8
  • Yasushi Fujimoto
    • 9
  • Shigemichi Iwae
    • 10
  • Kenji Okami
    • 11
  • Takashi Matsuzuka
    • 12
  • Kunitoshi Yoshino
    • 13
  • Ken-ichi Nibu
    • 14
  • Takakuni Kato
    • 15
  • Hiroshi Nishino
    • 16
  • Takahiro Asakage
    • 17
  • Ichiro Ota
    • 18
  • Morimasa Kitamura
    • 19
  • Akira Kubota
    • 20
  • Tsutomu Ueda
    • 21
  • Kaichiro Ikebuchi
    • 22
  • Akihito Watanabe
    • 23
  • Masato Fujii
    • 24
  1. 1.Department of Otolaryngology – Head and Neck SurgeryHokkaido University Graduate School of MedicineSapporoJapan
  2. 2.Head and Neck SurgeryNational Cancer Center Hospital EastKashiwaJapan
  3. 3.Head and Neck SurgeryMiyagi Cancer CenterSendaiJapan
  4. 4.Otolaryngology-Head and Neck SurgeryTohoku University School of MedicineSendaiJapan
  5. 5.Head and Neck Oncology, Japanese Foundation for Cancer ResearchCancer Institute HospitalTokyoJapan
  6. 6.Otorhinolaryngology-Head and Neck SurgeryNational Shikoku Cancer Center, MatsuyamaMatsuyamaJapan
  7. 7.Head and Neck SurgeryAichi Cancer CenterNagoyaJapan
  8. 8.Head and Neck SurgeryShizuoka Cancer CenterShizuokaJapan
  9. 9.OtolaryngologyNagoya University Graduate School of MedicineNagoyaJapan
  10. 10.Head and Neck SurgeryHyogo Cancer CenterAkashiJapan
  11. 11.OtolaryngologyTokai University School of MedicineIseharaJapan
  12. 12.OtolaryngologyFukushima Medical University School of MedicineFukushimaJapan
  13. 13.Otolaryngology-Head and Neck SurgeryOsaka Medical Center for Cancer and Cardiovascular DiseasesOsakaJapan
  14. 14.Otolaryngology-Head and Neck SurgeryKobe University Graduate School of MedicineKobeJapan
  15. 15.OtorhinolaryngologyJikei University School of MedicineTokyoJapan
  16. 16.Otolaryngology-Head and Neck SurgeryJichi Medical University School of MedicineShimotsukeJapan
  17. 17.Otolaryngology-Head and Neck SurgeryTokyo University School of MedicineTokyoJapan
  18. 18.Otolaryngology-Head and Neck SurgeryNara Medical UniversityNaraJapan
  19. 19.Otolaryngology-Head and Neck SurgeryKyoto University Graduate School of MedicineKyotoJapan
  20. 20.Head and Neck SurgeryKanagawa Cancer CenterYokohamaJapan
  21. 21.OtolaryngologyHiroshima University School of MedicineHiroshimaJapan
  22. 22.Otolaryngology-Head and Neck SurgeryKyoto Prefectural University of MedicineKyotoJapan
  23. 23.OtolaryngologyKeiyukai Sapporo HospitalSapporoJapan
  24. 24.OtorhinolaryngologyNational Tokyo Medical CenterTokyoJapan

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