Cervical lymph node metastasis in squamous cell carcinoma of the buccal mucosa: a retrospective study on pattern of involvement and clinical analysis

Hoda, Nadimul; Bc, Russum; Ghosh, Subhashis; Ks, Sridhar; B, V-D; Nathani, Jayesh

doi:10.4317/medoral.24016

Cited by 12 publications

(8 citation statements)

References 23 publications

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“…Just like other oral cavity cancers, such as cancer of the tongue, the patients with buccal cancer often have occult cervical lymph node metastases in the cN0 neck. Hoda et al reported that 145 out of 254 patients (57%) with buccal cancer who were treated surgically showed pathologically proven metastasis in the neck, out of which there were 56 patients showing occult metastasis [13]. Even in the early T stage of buccal cancer, cT2N0 tumors were demonstrated to be up to 10% of occult metastases in the literature [8], and the elective neck dissection (END) to cN0 neck was reported to improve cervical control rate [8] or disease specific survival [14].…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological Characteristics and Survival Outcomes of Patients with Buccal Squamous Cell Carcinoma: Results of a Multi-Institutional Study

et al. 2021

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Background and Objectives: To investigate clinicopathological characteristics and survival outcomes of patients with buccal cancer in Japan. Materials and Methods: This study was conducted using a database of 1055 patients with oral cancers treated between 2010 and 2017 at 12 institutions in Japan. Ninety-two patients (8.7%) with primary buccal cancer were extracted and clinicopathological characteristics and survival outcomes were compared between patients with buccal cancers and patients with other oral cancers. Results: Ages were significantly higher in the patients with buccal cancer (73 years old vs. 69 years old). Buccal cancer had less advanced cT stage and cN stage than other oral cancers. Overall 5-year survival (OS) was 80.6%, and recurrence-free 5-year survival (RFS) of buccal cancers was 67.8%, and there were no significant differences in survival compared with other oral cancers in terms OS or RFS (5y-OS: 82.5%, 5y-RFS: 74.4%). However, patients with stage IV buccal cancer showed poorer prognosis in terms of OS and RFS compared with the same stage patients with other oral cancer. Advanced T stage was the only factor independently associated with both OS and RFS of patients with buccal cancer in this study. Conclusions: Postoperative radiotherapy or chemoradiotherapy should be considered to improve survival outcome of buccal cancer patients, especially for the patients with advanced primary site disease or a higher cancer stage.

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Section: Discussionmentioning

confidence: 99%

Clinicopathological Characteristics and Survival Outcomes of Patients with Buccal Squamous Cell Carcinoma: Results of a Multi-Institutional Study

et al. 2021

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“…Cervical lymph node metastasis is a characteristic of locally advanced oral and oropharyngeal cancer and an important factor for prognosis. Adequate assessment and lymphadenectomy are extremely important for improving the survival rate and quality of life in locally advanced oral and oropharyngeal cancer [ 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Protection of the marginal mandibular branches of the facial nerves by different surgical procedures in comprehensive cervical lymphadenectomy for locally advanced oral and oropharyngeal cancer: a multicenter experience

et al. 2023

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Objective According to the different characteristics of patients and cervical lymph node metastasis of oral and oropharyngeal cancer, the marginal mandibular branches of facial nerves were treated by different surgical procedures, and the safety and protective effects of different surgical procedures were investigated. Methods One hundred ninety-seven patients with oral and oropharyngeal cancer satisfying the inclusion criteria were selected. According to the different characteristics of patients and cervical metastatic lymph nodes, three different surgical procedures were used to treat the marginal mandibular branches of the facial nerve: finding and exposing the marginal mandibular branches of the facial nerves at the mandibular angles of the platysma flaps, finding and exposing the marginal mandibular branches of facial nerves at the intersections of the distal ends of facial arteries and veins with the mandible, and not exposing the marginal mandibular branches of the facial nerves. The anatomical position, injury, and complications of the marginal mandibular branches of the facial nerves were observed. Results The marginal mandibular branches of the facial nerves were found and exposed at the mandibular angles of the platysma flaps in 102 patients; the marginal mandibular branches of facial nerves were found and exposed at the intersections of the distal ends of the facial arteries and veins with the mandibles in 64 patients; the marginal mandibular branches of facial nerves were not exposed in 31 patients; among them, four patients had permanent injury of the marginal mandibular branches of the facial nerves, and temporary injury occurred in seven patients. There were statistically significant differences in the protection of the mandibular marginal branch of the facial nerve among the three different surgical methods (P = 0.0184). The best protective effect was to find and expose the mandibular marginal branch of the facial nerve at the mandibular angle of the platysma muscle flap, and the injury rate was only 2.94%. Conclusion The three different surgical procedures were all safe and effective in treating the marginal mandibular branches of the facial nerves, the best protective effect was to find and expose the mandibular marginal branch of the facial nerve at the mandibular angle of the platysma muscle flap.

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“…Cervical lymph node metastasis is a characteristic of locally advanced oral and oropharyngeal cancer and an important factor for prognosis. Good control of lymph nodes is extremely important for improving the survival rate and quality of life in locally advanced oral and oropharyngeal cancer [15,16]. Lymphadenectomy is the gold standard for surgical treatment of cervical lymph node metastasis.…”

Section: Discussionmentioning

confidence: 99%

Protection of the Marginal Mandibular Branches of the Facial Nerves by Different Surgical Procedures in Comprehensive Cervical Lymphadenectomy for Locally Advanced Oral and Oropharyngeal Cancer: A Multicenter Experience

Zhao

Zen

Qiu

et al. 2022

Preprint

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Background and objective: Tumor treatment has been progressive. Targeted therapy and immunotherapy have contributed in the surgical success of several patients with advanced oral and oropharyngeal cancer. Surgery is the primary treatment for oral and oropharyngeal cancer, and cervical lymphadenectomy is crucial in surgery. Evidence has shown that submandibular glands can be preserved in cervical lymphadenectomy for early stage oral and oropharyngeal cancer; however, the removal of the submandibular glands is inevitable in cervical lymphadenectomy for locally advanced oral and oropharyngeal cancer. Nowadays, with individualized and precise treatment, the anatomy and protection of the marginal mandibular branches of the facial nerves have received increasing attention. In this study, according to the different characteristics of patients and cervical lymph node metastasis of oral and oropharyngeal cancer, the marginal mandibular branches of facial nerves were treated by different surgical procedures, and the safety and protective effects of different surgical procedures were investigated.Methods: From January 2014 to June 2021, 197 patients with oral and oropharyngeal cancer satisfying the inclusion criteria were selected from the Head and Neck Department of Shenzhen Otolaryngology Research Institute/Shenzhen Longgang Otolaryngology Hospital, Head and Neck Department of Gannan Medical University Affiliated Cancer Hospital, Department of Oral and Maxillofacial Surgery of the First Hospital of Qiqihar in Heilongjiang Province, and Department of Otorhinolaryngology-Head and Neck Surgery of First Affiliated Hospital of Gannan Medical University. All patients underwent radical surgery by comprehensive cervical lymphadenectomy or radical surgery plus repair and reconstruction. During the operation, the marginal mandibular branches of the facial nerves were treated and the submandibular glands were removed. According to the different characteristics of patients and cervical metastatic lymph nodes, three different surgical procedures were used to treat the marginal mandibular branches of the facial nerve: finding and exposing the marginal mandibular branches of the facial nerves at the mandibular angles of the platysma flaps, finding and exposing the marginal mandibular branches of facial nerves at the intersections of the distal ends of facial arteries and veins with the mandible, and not exposing the marginal mandibular branches of the facial nerves. The anatomical position, injury, and complications of the marginal mandibular branches of the facial nerves were observed.Results: The marginal mandibular branches of the facial nerves penetrated from the front or lower ends of the parotid glands. They were constantly located between the deep surface of the platysma and the superficial layer of the deep fascia cervicalis, and on the plane of the lower mandible. They crossed the superficial surface of the posterior facial veins, mandibular angles, and anterior facial veins from back to front and entered the deep surface of deltoid muscles at the distal ends of facial arteries and veins. Among the 197 oral and oropharyngeal cancer patients undergoing comprehensive cervical lymphadenectomy with excision of the submandibular glands, the marginal mandibular branches of the facial nerves were found and exposed at the mandibular angles of the platysma flaps in 102 patients (102/197, 51.78%); the marginal mandibular branches of facial nerves were found and exposed at the intersections of the distal ends of the facial arteries and veins with the mandibles in 64 patients (64/197, 32.49%); the marginal mandibular branches of facial nerves were not exposed in 31 patients (31/197, 15.73%); the two methods for finding the marginal mandibular branches of the facial nerves both successfully found the marginal mandibular branches. Among the 197 patients with oral and oropharyngeal cancer, four patients (4/197, 2.03%) had permanent injury of the marginal mandibular branches of the facial nerves. Among them, one patient (1/102,0.98%) had injury of the marginal mandibular branches of the facial nerves found and exposed at the mandibular angles of platysma flaps; one patient (1/64, 1.56%) had injury of the marginal mandibular branches of the facial nerves found and exposed at the intersections of the distal ends of the facial arteries and veins with the mandible; the marginal mandibular branches of the facial nerves were not found and exposed in two patients (2/31, 6.45%), and the differences were not statistically significant (P>0.05). Temporary injury occurred in seven patients (7/197, 3.55%). Among them, two patients (2/102, 1.96%) had injury of the marginal mandibular branches of the facial nerves found and exposed at the mandibular angles of platysma flaps; two patients (2/64, 3.13%) had injury of the marginal mandibular branches of the facial nerves found and exposed at the intersections of the distal ends of facial arteries and veins with the mandible; and the marginal mandibular branches of facial nerves were not found and exposed in three patients (3/31, 9.68%). The differences were not statistically significant (P>0.05). The patients were followed up for 6 to 90 months after surgery, and the functions were restored in all patients with temporary injury of the marginal mandibular branches of the facial nerves.Conclusion: The three different surgical procedures were all safe and effective in treating the marginal mandibular branches of the facial nerves. Finding and exposing the marginal mandibular branches of the facial nerves at the mandibular angles of the platysma flaps was suitable for those with larger and more lymph nodes in region Ib. Finding and exposing the marginal mandibular branches of the facial nerves at the intersections of the distal ends of facial arteries and veins with the mandible was suitable for those with larger and more lymph nodes in region IIa. Not exposing the marginal mandibular branches of the facial nerves was suitable for those without obvious lymph nodes in region Ib or region IIa. Intraoperatively, we should choose an appropriate method in dealing with the marginal mandibular branches of the facial nerves according to the different characteristics of patients and cervical metastatic lymph nodes as well as the proficiency of surgeons.

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Cervical lymph node metastasis in squamous cell carcinoma of the buccal mucosa: a retrospective study on pattern of involvement and clinical analysis

Cited by 12 publications

References 23 publications

Clinicopathological Characteristics and Survival Outcomes of Patients with Buccal Squamous Cell Carcinoma: Results of a Multi-Institutional Study

Clinicopathological Characteristics and Survival Outcomes of Patients with Buccal Squamous Cell Carcinoma: Results of a Multi-Institutional Study

Protection of the marginal mandibular branches of the facial nerves by different surgical procedures in comprehensive cervical lymphadenectomy for locally advanced oral and oropharyngeal cancer: a multicenter experience

Protection of the Marginal Mandibular Branches of the Facial Nerves by Different Surgical Procedures in Comprehensive Cervical Lymphadenectomy for Locally Advanced Oral and Oropharyngeal Cancer: A Multicenter Experience

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