Pathology of advanced buccal mucosa cancer involving masticator space (T4b)

Abstract

T4b buccal cancers have significant soft-tissue involvement in the masticator space. En bloc removal of all soft-tissues in masticator space is advocated to remove tumor contained within space. The compartment surgery provides an opportunity to achieve negative margins for cancers actually contained within masticator space.It is inappropriate to club all patients with masticator space involvement in one group.

Oral cancer involving masticator space (T4b): Review of literature and future directions

“…The patients with T4b classification tumors are considered unresectable and are mostly managed with palliative intent treatment. These tumors are often classified as borderline operable in clinical practice and a variety of treatment approaches have been used to manage them . The clinicians have continued to use their personal discretion to manage these patients.…”

“…The oral cancer with masticator space involvement is an advanced disease and one that is difficult to treat. Our understanding on this subject is very limited due to paucity in published literature . These patients form a significant clinical burden in developing countries.…”

Atlas of Head and Neck Cancer Surgery

“…All the specimens of patients who underwent compartment surgery were studied extensively to understand the pattern of disease spread in masticator space [ 4 ]. All the specimens of patients who underwent compartment surgery were studied extensively to understand the pattern of disease spread in masticator space [ 4 ].…”

Patterns of failure after postoperative intensity‐modulated radiotherapy for locally advanced buccal cancer: Initial masticator space involvement is the key factor of recurrence

“…9,10 Buccal cancer invading the masticator space, pterygoid plate, skull base, or internal carotid artery is defined as T4b disease and is considered very advanced local disease. [14][15][16][17] The aggressive behavior of buccal cancer, the resulting anatomic boundaries, and the change in lymphovascular drainage after surgery make the design of optimal RT very challenging. 12 Locally advanced buccal cancer with initial involvement or encasement of the masseter muscle, mandibular ramus, or lower part of the medial pterygoid muscle, might be considered resectable disease with favorable outcomes.…”

“…12 Locally advanced buccal cancer with initial involvement or encasement of the masseter muscle, mandibular ramus, or lower part of the medial pterygoid muscle, might be considered resectable disease with favorable outcomes. [14][15][16][17] The aggressive behavior of buccal cancer, the resulting anatomic boundaries, and the change in lymphovascular drainage after surgery make the design of optimal RT very challenging. Some unexpected recurrences have been disclosed after postoperative IMRT.…”