Nodal involvement and p16-staining in upper alveolar ridge and hard palate cancer

Aim:Upper alveolar ridge and hard palate squamous cancer is an infrequent malignancy.We evaluated factors associated with neck involvement and with p16-staining.Methods:Head and neck squamous-cell carcinoma(SCC)patients who went to Head and Neck Department between 1997 and 2011 were screened,and 73 resected upper alveolar ridge and 5 hard palate SCC were selected.Tumors with available tissue were stained with p16 immunohistochemistry.Results:Median age was 64.4 years,55.1%were female,and 73.1%were in clinical stage IV.Neck dissections were performed in 24 and pathologically confirmed node metastases were found in 19(24.3%).Cervical recurrence was found in 18 patients(23.1%)and was associated with histological grade(P=0.037).Three(7.3%)of 41 lesions were positive for p16 and tended to be younger(P=0.067).Lymphovascular invasion was associated with shorter disease-free survival(DFS)(P=0.026)and overall survival(OS)(P=0.021).Larger cT(P=0.019),perineural invasion(P=0.039)and neck dissection(P=0.010)were associated with shorter OS.Neck node involvement tended to have shorter DFS(31%vs.48.7%,P=0.278)and OS(25.1%vs.48.5%,P=0.340),and neck recurrence tended to have shorter OS(9.3%vs.52.3%,P=0.064).Conclusion:Neck involvement and recurrence are frequent in this location.P16-positive cases were present in 7.3%and tended to be associated with younger age.