Department of Surgical Oncology, Prince Aly Khan Hospital, Mumbai, Maharashtra, India.
Laryngoscope. 2013 Jan;123(1):177-80. doi: 10.1002/lary.23707. Epub 2012 Sep 5.
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.
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.
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.
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.
目的/假设：本研究旨在研究经口广泛切除早期 T1-2N0 颊黏膜鳞状细胞癌的结果。
这是一项对在三级保健医院接受经口广泛切除治疗的早期局限性颊黏膜鳞状细胞癌的回顾性研究。
共分析了 156 例患者。110 例（70.5%）无复发，15 例（9.6%）局部复发，24 例（15.4%）区域转移，3 例（1.9%）局部区域复发，4 例（2.6%）在中位随访 48 个月后发生第二原发肿瘤。大多数局部复发患者（14 例，93.3%）和区域转移患者（24 例，100%）可通过治疗挽救。相比之下，所有 3 例局部区域复发患者均无法挽救。本研究组中，36 例（78%）的复发病例均发生在初次治疗后 2 年内。在 143 例有吸烟/嚼槟榔习惯的病例中，有 62 例（43.4%）出现癌前病变，与 P 值为 0.012 的统计学显著相关。15 例 T2 期病例出现颈部区域淋巴结转移，而仅 9 例 T1 期病例出现颈部区域淋巴结转移，P 值为 0.032。3 年总生存率和无病生存率分别为 91.7%和 70.5%。
经口广泛切除似乎是治疗 T1-2N0 局限性颊黏膜鳞状细胞癌的一种充分的方法。只有在 T2N0 病例中才应考虑预防性选择性颈部淋巴结清扫术，因为只有疾病的 T 分期与转移性颈部淋巴结的发展有显著相关性。
