Management of the clinically node negative neck in squamous cell carcinoma of the maxilla

Squamous cell carcinomas of the maxilla (MSCC) may present with or without lymph node metastasis in the neck. Lymph node involvement is the most important prognostic factor for these malignancies [1–4]. A therapeutic neck dissection, radiotherapy or both, is indicated in case of proven lymph node metastasis in the neck. For MSCC with clinically node negative (N0) neck, a 'watch and wait' strategy for the neck is traditionally followed because the metastatic risk is assumed to be low. However, nowadays this 'watch and wait' strategy has become a matter of debate because the impression arises that occult metastases occur more frequently than previously assumed.

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