Squamous cell carcinoma of the buccal mucosa: A retrospective analysis

Abstract

Objectives: To review our institution’s experience with 23 previously untreated patients with buccal squamous cell carcinoma and describe its clinical course, treatment, outcomes, and prognosis. Methods: Retrospective chart review of 60 patients seen at the University of California, San Francisco (UCSF) Head and Neck Cancer Center identified using the UCSF tumor registry database from 1972 to 2003. Of these, 23 patients were initially treated exclusively at UCSF. Patients who were previously treated elsewhere or whose lesions initially arose in other oral cavity sites and secondarily involved the buccal mucosa were excluded. Results: Patients of all T stages had an almost 34% locoregional recurrence rate (T1 25%, T2 37.5%, T3 33%, T4 40%). Five-year survival rates were as follows: T1 100%, T2 75%, T3 40%, and T4 75%. Eight patients were treated with surgical excision and postoperative radiation therapy, 6 patients with primary radiation therapy, and 9 patients underwent surgical excision alone. The locoregional recurrence rates were 0%, 83%, and 33%, respectively. The 5-year survival rates were 88%, 67%, and 89%, respectively. Perineural invasion was also associated with locoregional recurrence. Follow-up was an average of 4.1 years. Conclusions: Buccal squamous cell carcinoma is an aggressive oral cavity cancer with a historically high rate of locoregional recurrence and poor survival. For all stages, locoregional control and survival rates may be improved with surgical excision followed by radiation therapy rather than by treatment with either radiation or surgical therapy alone.