Sequential Therapy of Advanced Buccal Mucosa Squamous Cell Carcinoma: Three-Year Outcome

Abstract

Squamous cell carcinoma (SCC) of the buccal mucosa is aggressive and requires multimodal treatment. The objective of this study was to evaluate the outcome of sequential therapy (neoadjuvant therapy plus surgery plus radiotherapy) in advanced buccal SCC and explore the prognostic factors. In this retrospective cohort study, patients with advanced buccal cancer who received neoadjuvant chemotherapy (cisplatin, docetaxel, and 5-fluorouracil) followed by surgery and radiotherapy in the authors' department were reviewed. The outcomes of chemotherapy and surgery were analyzed. Overall survival (OS) and disease-free survival (DFS) were calculated using the Kaplan-Meier method. The prognostic values of age, gender, histologic grade, lymph node status, tumor stage, pathologic response, and adverse pathologic features were explored using the log-rank test and the Cox regression model. From 2008 to 2011, data from 22 patients were analyzed. The overall response rate of chemotherapy was 72.7%. The pathologic complete or partial response rate was 40.9%. The median follow-up was 36 months. The 2-year DFS and OS rates were 63.3% and 67.2%, respectively. Male and younger patients showed an association with poor outcome. Multivariate analysis showed that gender was a predictive factor with respect to DFS and OS (P = .023 and .014, respectively). Sequential therapy (neoadjuvant therapy plus surgery plus radiotherapy) tends to be effective for advanced buccal cancer. Female patients have better survival.