Prognostic Factors of Squamous Cell Carcinoma of the Buccal Mucosa: A Retrospective Study of 168 Cases in North China

Abstract

Buccal mucosa squamous cell carcinoma (BSCC) is considered a rare and aggressive malignancy that has a high rate of locoregional recurrence. The aim of this study was to analyze the outcome of surgical therapy as a treatment for BSCC in a North Chinese population over a period of 14 years. A retrospective study was performed by reviewing the records and pathologies of 168 patients with BSCC who were treated at the Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Peking University, from June 1999 to September 2013. The rates of local, regional, and locoregional recurrence were 47.3%, 13.5%, and 6.8%, respectively. The neck metastasis rate in patients classified as having cN0 was 28.4%, and the occult metastasis rate in patients with BSCC stages T2 to T4 was higher than 15%. Neck metastases were most common at levels I and II. The 3-year disease-free survival, overall survival, and disease-specific survival rates were 60.6%, 74.6%, and 78.0%, respectively. Gender, T stage, pathologic node status, and pathologic grade were significant factors in determining disease-specific survival. However, only pathologic node status (P = .002) was an independent predictive factor of 3-year disease-specific survival. Buccal carcinoma is an aggressive disease with high rates of local and regional recurrence. In seeking to offer better prognoses and quality of life, extensive resection of the primary tumor, supraomohyoid neck dissection, and preferred free flap reconstruction are the therapies that have been recommended and used in the authors' hospital during the past 10 years.