Patterns of Initial Lymph Node Involvement and Recurrence in Patients With Maxillary Sinus Squamous Cell Carcinoma.

Head Neck

Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.

Published: September 2025


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Article Abstract

Background: Determining whether to treat the elective cervical lymph node (LN) area remains a dilemma in maxillary sinus squamous cell carcinoma (SCC). This study analyzed the patterns of initial LN involvement and recurrence to guide treatment strategies.

Methods: We retrospectively reviewed 119 patients with maxillary sinus SCC treated between 2005 and 2023. Patients received definitive concurrent chemoradiotherapy, neoadjuvant therapy followed by local treatment, or upfront surgery with or without adjuvant radiotherapy.

Results: Among 119 patients, 28 (23.5%) had clinical LN involvement at diagnosis, primarily at ipsilateral neck levels I and II. Regional failure occurred in 18 (19.8%) cN0 and 9 (32.1%) cN+ patients, with ipsilateral level II being the most common site. Contralateral failures were frequent in cN+ patients. Distant metastases occurred in 17 patients (14.3%), predominantly in the lungs.

Conclusion: Understanding LN involvement and recurrence patterns can refine radiation field design and follow-up strategies in maxillary sinus SCC.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12338011PMC
http://dx.doi.org/10.1002/hed.28170DOI Listing

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