Outcome of per oral wide excision of T1-2 N0 localized squamous cell cancer of the buccal mucosa--analysis of 156 cases.

OBJECTIVES/HYPOTHESIS: The purpose of the study was to study the outcomes of per oral wide excision of early T1-2 N0 squamous cell cancer of buccal mucosa.

METHODS

This is a retrospective study of early and localized squamous cell cancer of the buccal mucosa treated with peroral wide excision at a tertiary-care hospital.

RESULTS

A total of 156 patients were analyzed. One hundred ten patients (70.5%) had no recurrence, whereas 15 (9.6%) had a local recurrence, 24 (15.4%) had regional metastasis, three (1.9%) had locoregional recurrence, and four (2.6%) developed second primary tumors over a median follow-up of 48 months. Most patients with local recurrences (14 patients, 93.3%) and regional metastases (24 patients, 100%) could be salvaged with treatment. In contrast, all three cases with locoregional could not be salvaged. Most of the cases with recurrences, 36 (78%) in this study group, occurred within 2 years of primary treatment. Out of 143 cases with a habit of tobacco/beetel quid chewing, premalignancy was seen in 62 (43.4%) cases, showing a statistically significant association with P-value of 0.012. Fifteen (21.4%) cases with stage T2 developed regional neck nodes, while only 9 (10.5%) cases with stage T1 developed regional neck nodes with P-value of 0.032. Three-year overall survival rate and disease-free survival rates were 91.7% and 70.5%, respectively.

CONCLUSIONS

Peroral wide excision seems to be an adequate procedure for T1-2N0 localized squamous cancer of buccal mucosa. Prophylactic selective neck dissection should be considered in only T2 N0 cases as only T stage of the disease could be significantly correlated with the development of the metastatic neck nodes.