Squamous cell carcinoma of the buccal mucosa: An aggressive cancer requiring multimodality treatment

Abstract

Background. In our clinical practice, we have observed a high incidence of locoregional failure in squamous cell carcinoma (SCC) of the buccal mucosa. We analyze our treatment results of this cancer and compare these results with those in the literature. We intend to define the pattern and incidence of failure of buccal cancer and provide information for the design of a better multimodality treatment.Methods. During the period from 1983 through 2003, 121 previously untreated patients with M0 stage SCC of the buccal mucosa were treated with a curative intent at our hospital. Twenty-seven patients received surgery alone, 36 had radiotherapy alone, and 58 underwent surgery plus postoperative radiotherapy.Results. The 5-year locoregional control, overall survival, and cause-specific survival rates for all patients were 36.3%, 34.3%, and 36.9%, respectively. The locoregional recurrence rate was 57% for all patients, with 80% occurring in the primary site alone. Patients with T1 -2N0 disease who received surgery alone still had a high local recurrence incidence of 41%. For patients with locally advanced disease, surgery plus postoperative radiotherapy achieved better overall survival and locoregional control rates than surgery alone or radiotherapy alone. T classification was the only prognostic factor affecting locoregional control and survival in the surgery alone group, whereas N classification and skin invasion predicted a poorer survival for the surgery plus postoperative radiotherapy group.Conclusions. SCC of the buccal mucosa is an aggressive cancer with a high locoregional failure rate even in patients with T1 -2N0 disease. Possible reasons include inadequate treatment and an intrinsically aggressive nature. Postoperative radiotherapy has resulted in a better locoregional control rate for patients with T3 -4 or N+ disease and should also be considered for patients with T1 -2N0 disease for whom adjuvant therapy after radical surgery currently is not recommended by most guidelines. A 2005 Wiley Periodicals, Inc. Head Neck 28: 150 -157, 2006

Advanced Stage Buccal Carcinoma: Effect of Local Extension on Prognosis

“…Similar with our findings, the incidence of lymph node metastasis of buccal carcinoma ranged as 0%-80% for T3 tumors and 50%-63% for T4a tumors in literature (2,3,8).…”

“…The locoregional failure rate was reported as 39.3% for patients with T1-2N0 disease treated with surgery alone (8). In our series, the locoregional control for patients with T3-T4a disease was 50% after surgery and adjuvant radiotherapy.…”

“…There are some differences between whites and Asians, such as incidence, presenting age, and etiologic factors (1, 4). The incidence of buccal carcinoma is much higher in Asia and Taiwan because of the high prevalence of betel quid chewing (1,7,8). In Turkey, the major etiologic factors are cigarette and alcohol abuse, similar to European countries.…”

Combined Targeting of Epidermal Growth Factor Receptor, Signal Transducer and Activator of Transcription-3, and Bcl-XLEnhances Antitumor Effects in Squamous Cell Carcinoma of the Head and Neck

“…UM-22B and PCI-15B cell lines were derived from cervical lymph node metastases from patients with head and neck squamous cell carcinomas as described previously (Lin et al, 2006). UM-22B cells were provided by Dr. Thomas Carey (University of Michigan) (Ala-aho et al, 2004).…”

Oral cavity squamous cell carcinoma survival by biopsy type: a cancer registry study

“…This is consistent with previous publications whereby buccal mucosal lesions have been associated with poorer survival rates and palatal SCCs with better survival rates. 18,19 The results of this study suggest that biopsy type, either incisional or excisional, does not appear to be associated with survival of Stage I or Stage II oral SCC patients. These epidemiological findings support the view that incisional biopsy of oral SCCs constitutes a safe procedure.…”