Lubek Joshua E, Dyalram Donita, Perera Esther H K, Liu Xinggang, Ord Robert A
Department of Oral and Maxillofacial Surgery, University of Maryland, Baltimore, MD 21117, USA.
J Oral Maxillofac Surg. 2013 Jun;71(6):1126-31. doi: 10.1016/j.joms.2012.12.006. Epub 2013 Feb 8.
Squamous carcinoma of the buccal mucosa is relatively uncommon in the North American population. It is considered an aggressive cancer, with difficulty in obtaining negative surgical margins and poor locoregional control. This single-institution retrospective analysis attempted to identify prognostic variables, treatment outcomes, and survival patterns of patients with buccal carcinoma.
A retrospective chart review of all patients with buccal carcinoma treated in the Department of Oral and Maxillofacial Surgery, University of Maryland from 1992 through 2008 was conducted. Thirty newly diagnosed and previously untreated patients were reviewed and their outcomes data were analyzed.
Thirteen female and 17 male patients were identified (mean age, 64 yr). Eighteen patients had early-stage disease (stages I to II). Fifteen patients (50%) developed recurrence, with 13 patients developing local recurrence despite 80% of patients achieving negative surgical margins. The overall nodal metastasis rate was 43%, with an occult nodal rate of 32%. Overall 2- and 5-year survival rates were 69% and 53%, respectively. Thirty-nine percent of patients not receiving adjuvant therapy developed recurrence. Early recurrence tended to occur more commonly and was a poor prognostic indicator of successful salvage.
Buccal carcinoma is an aggressive disease, with high rates of locoregional disease recurrence independent of surgical margin status. Elective neck dissection and adjuvant therapy should be considered for early-stage disease. Successful salvage is rare in cases of early recurrence.
颊黏膜鳞状细胞癌在北美人群中相对少见。它被认为是一种侵袭性癌症，手术切缘难以达到阴性，局部区域控制效果不佳。这项单机构回顾性分析试图确定颊癌患者的预后变量、治疗结果和生存模式。
对1992年至2008年在马里兰大学口腔颌面外科接受治疗的所有颊癌患者进行回顾性病历审查。对30例新诊断且未经治疗的患者进行了审查，并分析了他们的结局数据。
确定了13例女性和17例男性患者（平均年龄64岁）。18例患者为早期疾病（I至II期）。15例患者（50%）出现复发，尽管80%的患者手术切缘为阴性，但仍有13例患者出现局部复发。总的淋巴结转移率为43%，隐匿性淋巴结转移率为32%。总的2年和5年生存率分别为69%和53%。未接受辅助治疗的患者中有39%出现复发。早期复发往往更常见，是成功挽救的不良预后指标。
颊癌是一种侵袭性疾病，局部区域疾病复发率高，与手术切缘状态无关。对于早期疾病，应考虑选择性颈清扫和辅助治疗。早期复发的病例很少能成功挽救。
