{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T07:13:06Z","timestamp":1793517186104,"version":"4.5.0"},"reference-count":56,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,5,8]],"date-time":"2021-05-08T00:00:00Z","timestamp":1620432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Management of the node\u2010negative neck in oral maxillary squamous cell carcinoma (SCC), encompassing the hard palate and upper alveolar subsites of the oral cavity, is controversial, with no clear international consensus or recommendation regarding elective neck dissection in the absence of cervical metastases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess the occult metastatic rate in patients with clinically node negative oral maxillary SCC; both as an overall metastatic rate, and a comparison of patients managed with an elective neck dissection at index surgery, compared to excision of the primary with clinical observation of the neck.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>A systematic review was performed by two independent investigators for studies relating to oral maxillary SCC and analysed according to PRISMA criteria. Data were extracted from Pubmed, Ovid MEDLINE, EMBASE, and SCOPUS via relevant MeSH terms. Grey literature was searched through Google Scholar and OpenGrey. Five hundred and fifty\u2010three articles were identified on the initial search, 483 unique articles underwent screening against eligibility criteria, and 29 studies were identified for final data extraction. Incidence of occult metastases in patients with clinically node negative oral maxillary SCC was identified either on primary elective neck dissection or on routine follow up. Meta\u2010analyses were performed. Of 553 relevant articles identified on initial search, 29 were included for analysis. The pooled overall rate of occult metastases in patients initially presenting with clinically node\u2010negative disease was 22.2%. There is a statistically significant effect of END on decreasing regional recurrence demonstrated in this study (RR 0.36, 95% CI 0.24, 0.59).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results of this systematic review and meta\u2010analysis suggest elective neck dissection for patients presenting with hard palate or upper alveolar SCC, even in a clinically node negative neck.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.1410","type":"journal-article","created":{"date-parts":[[2021,5,9]],"date-time":"2021-05-09T06:48:20Z","timestamp":1620542900000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Systematic review and meta\u2010analysis of cervical metastases in oral maxillary squamous cell carcinoma"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7253-3119","authenticated-orcid":false,"given":"Clemente","family":"Chia","sequence":"first","affiliation":[{"name":"Monash Health  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seraphina","family":"Key","sequence":"additional","affiliation":[{"name":"Monash University  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zubair","family":"Hasan","sequence":"additional","affiliation":[{"name":"Monash Health  Clayton Victoria Australia"},{"name":"Westmead Hospital  Westmead New South Wales Australia"},{"name":"University of Sydney  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sohaib","family":"Virk","sequence":"additional","affiliation":[{"name":"University of New South Wales  Randwick New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faruque","family":"Riffat","sequence":"additional","affiliation":[{"name":"University of Sydney  Camperdown New South Wales Australia"},{"name":"Chris O'Brien Lifehouse  Camperdown New South Wales Australia"},{"name":"Macquarie University Hospital Macquarie University  Macquarie Park New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0936-6555(98)80055-1"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.2890080202"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1994.01880310005001"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1506007"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-019-0587-2"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032641"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032646"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1758-3284-2-9"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.22957"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24302"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2011.08.012"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.20517\/2347-9264.2016.18"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24274"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2016.05.021"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27627"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.25706"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20054"},{"issue":"8","key":"e_1_2_10_19_1","first-page":"715","article-title":"Primary squamous cell carcinoma of the maxillary alveolus in a 10\u2010year\u2010old girl","volume":"73","author":"Binahmed A","year":"2007","journal-title":"J Can Dent Assoc"},{"issue":"7","key":"e_1_2_10_20_1","first-page":"1221","article-title":"Lateral retropharyngeal node metastasis from carcinoma of the upper gingiva and maxillary sinus","volume":"19","author":"Kimura Y","year":"1998","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2006.08.005"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1053\/joms.2001.19297"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2004.10.003"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2009.04.015"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0006-341X.2000.00455.x"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1411"},{"key":"e_1_2_10_29_1","unstructured":"Oxford Centre for Evidence\u2010Based Medicine. (2011).OCEBM Levels of Evidence Working Group. The Oxford 2011 levels of evidence."},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2013.08.011"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1159\/000480351"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24079"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oooo.2013.07.011"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2019.12.008"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/014556131609510-1103"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2010.04.005"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2007.12.017"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21631"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maxilo.2016.02.003"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21547"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2009.07.012"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e3181f404df"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1259\/dmfr\/25125369"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24511"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2014.05.020"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2011.09.006"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2018.12.008"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.20517\/2394-4722.2017.66"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000233607.41540.28"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e3181d878d1"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tripleo.2009.11.035"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23398"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2014.12.034"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1368-8375(00)00136-6"},{"key":"e_1_2_10_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2014.10.020"},{"key":"e_1_2_10_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2014.06.006"},{"key":"e_1_2_10_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oooo.2013.01.005"}],"container-title":["Cancer Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cnr2.1410","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cnr2.1410","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cnr2.1410","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T08:15:37Z","timestamp":1693210537000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cnr2.1410"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,8]]},"references-count":56,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1002\/cnr2.1410"],"URL":"https:\/\/doi.org\/10.1002\/cnr2.1410","archive":["Portico"],"relation":{},"ISSN":["2573-8348","2573-8348"],"issn-type":[{"value":"2573-8348","type":"print"},{"value":"2573-8348","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,8]]},"assertion":[{"value":"2021-01-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e1410"}}