Is elective neck dissection needed in clinically N0 neck in maxillary cancer?

it is in cancers of the maxillary sinus. However, there have been no randomized prospective studies regarding occult metastasis of these cancers. Traditionally, elective neck dissection of clinically N0 neck is delayed after primary resection of maxillary cancer. Recently, many authors have agreed that regional metastasis of maxillary cancer is aggressive and comparable to cancers of tongue and mouth floor. Consequently, they recommend elective neck dissection at the time of primary tumor resection. Simental et al. noted that maxillary cancer of the hard palate and alveolus behave like lower gingival cancer, not like sinonasal cancer, and drained level I, II, and III. Also, the rate of occult metastasis of maxillary oral mucosa cancer is very high, and most recent reports have recommended elective neck dissection in N0 neck. Salvage surgery may be unsuccessful in cases of regional failure after primary resection. Elective neck dissection is highly recommended in cancers of the maxillary gingiva, alveolus, and hard palate for regional control. Elective neck dissection is also recommended in cases of locally-advanced maxillary sinus cancer. For regional control, many authors suggest that elective neck dissection is better than radiation therapy, because salvage surgery after radiation therapy can be very difficult.