Outcome of per oral wide excision of T1‐2 N0 localized squamous cell cancer of the buccal mucosa—analysis of 156 cases

Abstract

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.