Maxillary Alveolar Carcinoma: Risk of Recurrence and its Relation with Prognostic Indicators

Background: Maxillary Alveolar carcinoma is a relatively uncommon entity with occurrence reported between 3.5 to 10% of all oral cancers. Recurrence when occurs locally are particularly difficult to treat due to the close proximity of this region to the infratemporal fossa and the base of skull. There is also a debate when to perform elective neck dissection in these patients.

Objectives: The aim of this study was to identify cases with recurrence and correlate its association with various prognostic factors and disease free survival in these patients.

Methodology: Overall, 15 cases were identified with maxillary alveolar carcinomas that were treated between 2011 to 2015. Eight of these cases were Squamous cell carcinomas, 5 Adeno carcinomas and 2 Adenocystic carcinomas. T stages, N stage, grade of tumor, surgical margin involvement by the tumor, presence of perineural and lymphovascular invasion were identified as prognostic indicators. The chi-square and Pearson correlation tests were applied to analyze the association between recurrence and these prognostic factors.

Results: Recurrence developed in 3 SCC (37.5%) and 1 ADC (20%) patient during the three years period following the treatment. Among the SCC patients, 2 recurrences were local and 1 regional. Recurrence was found to have a strong positive correlation with T stage (r=0.330, p=0.271), surgical margin involvement (r=0.575, p=0.566) and three years disease free survival (r=0.959, p=0.000). A weak positive correlation was also established with tumor grade (r=0.155, p=0.0613) and perineural invasion (r=0.149, p =0.725).

Keywords: Oral squamous cell carcinoma; Maxillary alveolus; Hard palate; Prognostic factors; Survival rates; Recurrence