Buccal Squamous Cell Carcinoma Research Articles

Identification and profiling of microRNAs expressed in oral buccal mucosa squamous cell carcinoma of Chinese hamster

MicroRNAs are known to play essential role in the gene expression regulation in cancer. In our research, next-generation sequencing technology was applied to explore the abnormal miRNA expression of oral squamous cell carcinoma (OSCC) in Chinese hamster. A total of 3 novel miRNAs (Novel-117, Novel-118, and Novel-135) and 11 known miRNAs (crg-miR-130b-3p, crg-miR-142-5p, crg-miR-21-3p, crg-miR-21-5p, crg-miR-542-3p, crg-miR-486-3p, crg-miR-499-5p, crg-miR-504, crg-miR-34c-5p, crg-miR-34b-5p and crg-miR-34c-3p) were identified. We conducted functional analysis, finding that 340 biological processes, 47 cell components, 46 molecular functions were associated with OSCC. Meanwhile the gene expression of Caspase-9, Caspase-3, Bax, and Bcl-2 were determined by qRT-PCR and the protein expression of PTEN and p-AKT by immunohistochemistry. Our research proposed further insights to the profiles of these miRNAs and provided a basis for investigating the regulatory mechanisms involved in oral cancer research.

Dissection of posterior triangle and lower deep jugular lymph node is mandatory in therapeutic neck dissection as a part of treatment for squamous cell carcinoma of oral cavity with clinically N1 neck

<p class="abstract"><strong>Background:</strong> In India oral cancer is the commonest malignant neoplasm, accounting for 20-30% of all cancers. Southern India presents the highest oral cancer incidence rates among women worldwide.</p><p class="abstract"><strong>Methods:</strong> This study was conducted in R. L. Jalappa Hospital and Research Centre and SDU Medical College Kolar, Karnataka. Thirty patients having oral squamous cell carcinoma with clinically N<sub>1 </sub>neck undergoing modified radical neck dissection between December 2010 and June 2012 were enrolled in the study. The objective of study was to determine whether dissection of posterior triangle and lower deep jugular lymph node is mandatory in therapeutic neck dissection as a part of treatment for squamous cell carcinoma of oral cavity with clinically N<sub>1 </sub>neck. </p><p class="abstract"><strong>Results:</strong> Out of 24 patients, 16 patients underwent wide excision with hemimandibulectomy. In these 16 cases, 2 patients had reconstruction with double flap while rest 14 cases with island pectoralis major myocutaneous flap. Out of remaining 8 patients, 2 patients underwent marginal mandibulectomy. In all these 8 patients, reconstruction was done using nasolabial flap in 1 patient, buccal pad of fat in 2 patients, masseter flap in 1 patient and forehead flap in 4 patients. In carcinoma anterior 2/3<sup>rd</sup> tongue, all 6 patients underwent hemiglossectomy with simultaneous modified radical neck dissection.</p><p class="abstract"><strong>Conclusions:</strong> It was concluded that during neck dissection, it may be oncologically safe to avoid level IV and level V clearance in buccal mucosa squamous cell carcinoma with N<sub>1</sub> neck.</p>

Multiple oral cancer development-Clinico-pathological features in the Hong Kong population.

Multiple squamous cell carcinoma (SCC) development within the oral cavity is an important consequence of mucosal field cancerization. We have previously profiled contemporaneous demographics and confirmed a rising incidence of oral cancer within the Hong Kong population. In this further study, we sought to characterize the presenting clinico-pathological features and clinical outcome consequent upon multiple primary tumour (PT) development. Having accessed the Hong Kong Hospital Authority (HA) database to identify new cases of oral SCC diagnosed during an 18-year period (November 1999 to October 2018), specific clinico-pathological data were retrieved for patients who developed multiple oral SCCs during the study period. Out of 6706 identified SCC cases, 769 patients (11.5%) developed multiple PTs, most commonly 2 (663) but 3 (91), 4 (12), 5 (2) and 6 (1) were also observed. The male to female ratio was 2.25 to 1 (P=.004), with female patients significantly older at first tumour presentation (P=.002), demonstrating longer periods before second PT development (P=.001) and better long-term survival than males (P=.001). Buccal mucosa (143), oropharynx (134) and tongue (112) were the sites most frequently affected by second tumours. Whilst buccal SCC showed a propensity for subsequent buccal tumour development (60), oropharynx primaries developed second PTs most frequently on the tonsil (28) and tongue (27). Tongue primaries were associated with second PTs on the floor of mouth (61) and oropharynx (57). Development of multiple oral cancers is a significant risk in Hong Kong, particularly for male patients. Following initial tumour management, regular and careful patient follow-up is important for early recognition of multiple SCC development.

Ipsilateral Neck Irradiation for Postoperative Lateralized Buccal Mucosa Squamous Carcinoma with Extranodal Extension: Propensity Analysis

The presence of extranodal extension (ENE) is the most significant risk factor for tumor control in head and neck squamous cell carcinoma (HNSCC). Concomitant chemoradiotherapy has been the standard of care for postoperative HNSCC. However, ipsilateral or bilateral radiotherapy for well-lateralized HNSCC is still controversial. We try to evaluate whether ipsilateral irradiation is safe for ENE-positive patients with well-lateralized buccal mucosa squamous cell carcinoma (BMSCC). Data of 186 well-lateralized BMSCC patients with ENE treated by postoperative ipsilateral RT or bilateral RT from January, 1997 to December, 2016 were included in this retrospective analysis. Patients in both arms were matched using the propensity score method, with 1:2 ratio matching from the ipsilateral RT group and the bilateral RT group in 10 key clinicopathological features. All outcomes were evaluated from the date of radical surgery. Primary endpoint was three-year contralateral neck control (CLNC). Secondary endpoints were three-year overall survival (OS), progression free survival (PFS), local control (LC), regional control (RC) and distant metastasis-free survival (DMFS). After matching, 123 patients (45 patients in ipsilateral RT group and 78 patients in bilateral RT group) were selected for analysis. The median follow-up time was 36.3 months (range 3.6-218.5). Cox regression analysis revealed that ENE number ≥ 4 is the only prognostic factor in all endpoints. RT field (ipsilateral RT vs. bilateral RT) did not have impact in three-year CLNC (85.6% vs. 89.1%, p = 0.75), OS (53.2% vs. 57.4%, p = 0.23), PFS (46.5% vs. 48.6%, p = 0.52), LC (74.6% vs. 77.4%, p = 0.78), RC (79.9% vs. 76.2%, p = 0.47) and DMFS (70.7% vs. 72.0%, p = 0.50). Ipsilateral neck irradiation treatment did not have worse outcomes for the postoperative BMSCC patients with ENE compared with bilateral neck treatment. The number of ENE is the most important prognostic factor in postoperative BMSCC patients with ENE.

Sequential alterations of Stensen’s duct and parotid gland after radical surgeries in buccal cancer

ObjectivesThe marsupialization of Stensen's duct after buccal cancer excision and free flap reconstruction has seldom been reported. In this study, we evaluated the alteration in Stensen's duct and parotid gland, without marsupialization or relocation, between the time of surgery and 24 months postoperatively to determine whether ductal management is needed in patients with buccal squamous cell carcinoma (BSCC). MethodsEighty-five patients with BSCC receiving primary radical surgery and free flap reconstruction were recruited. Alterations in Stensen's duct and parotid gland were assessed by computed tomography during the postoperative period. ResultsThe 81 males and 4 females enrolled in study had a tumor status of cT2 (n = 52, 61%) or cT3 (n = 33, 39%). In total, 52 (61%) patients received surgery alone, and 33 (39%) received adjuvant concurrent chemoradiotherapy (CCRT) postoperatively. Stensen's duct on the affected side was significantly dilated compared to the non-affected side (p < 0.001). The difference in diameter of Stensen's duct between the surgery plus CCRT group and the surgery alone group was not significant (p > 0.05), indicating that changes in parotid gland occurred mainly due to surgery. In both the surgery and surgery plus CCRT groups, inflammation of parotid gland had regressed by 24 months. ConclusionsStensen's duct in BSCC dilatation peaked in the 3rd month after surgery. Changes in parotid gland on the surgically treated side regressed into fatty change by 24 months after surgery.

HSPD1 repressed E-cadherin expression to promote cell invasion and migration for poor prognosis in oral squamous cell carcinoma

Buccal mucosa squamous cell carcinoma (BMSCC) is one of major subsites of oral cancer and is associated with a high rate of metastasis and poor prognosis. Heat shock proteins (HSPs) act as potential prognostic biomarkers in many cancer types. However, the role of HSPD1 in oral cancer, especially in BMSCC, is still unknown. Through data analysis with The Cancer Genome Atlas (TCGA), we found the association of HSPD1 gene expression with tumorigenesis and poor prognosis in oral cancer patients. Our cohort study showed that higher HSPD1 protein level was associated with tumorigenesis and poor prognosis in BMSCC patients with lymph node invasion, suggesting that HSPD1 may be involved in tumor metastasis. Moreover, knockdown of HSPD1 induced E-cadherin expression and decreased the migration and invasion of BMSCC cells. In contrast, ectopic expression of HSPD1 diminished E-cadherin expression and promoted the migration/invasion of BMSCC cells. Further, HSPD1 regulated RelA activation to repress E-cadherin expression, enhancing the migration and invasion of BMSCC cells. Furthermore, HSPD1 protein level was inversely correlated with E-cadherin protein level in tumor tissues and co-expression of high HSPD1/low E-cadherin showed a significant association with poor prognosis in BMSCC patients. Taken together, HSPD1 might repress E-cadherin expression and promote metastatic characters of BMSCC cells for poor prognosis of BMSCC patients.

Prognostic determinants of locally advanced buccal mucosa cancer: Do we need to relook the current staging criteria?

ObjectivesCurrent guidelines advocate non-surgical treatment for T4b buccal mucosa carcinoma with surgery preferred in other stages. We investigated oncologic outcomes of this cohort in comparison with T4a cohort, treated by similar multi-modality approach of primary surgery followed by adjuvant treatment and identified prognostic determinants of survival. Materials and methodsOncologic outcome of prospectively accrued 282 patients with cT4a and cT4b buccal mucosa squamous cell carcinoma were evaluated for overall survival (OS) and disease free survival (DFS) at 2 years of the whole cohort and for the subgroups of T4a and T4b patients. Multivariate Cox proportional hazards regression analysis was performed to identify prognostic determinants. ResultsOf 277 eligible patients treated and followed for a median period of 21 months, the OS was comparable between T4a and T4b as 64% vs 58%, (p = 0.354). The DFS between the two subgroups was 64% vs 61%, (p = 0.316). Although there was 47% pathologic down staging from the clinical stage, there was no significant difference in oncologic outcome between pT4a and pT4b (OS, 57% vs 58% for T4a and T4b, p = 0.687; DFS, 58% vs 60% for T4a and T4b, p = 0.776). On multivariate analysis, extra capsular spread (p = 0.042), lateral pterygoid muscle involvement (p = 0.035) and defaulting adjuvant treatment (p < 0.001) were independent predictors of outcome for the T4b cohort when other factors were controlled. ConclusionsPrimary surgery followed by adjuvant chemo-radiotherapy offers comparable results in selected T4b gingiva and buccal mucosal cancer, suggesting the need to relook the staging criteria for oral cavity cancer.

Comparison of the reconstruction of through-and-through cheek defects involving the labial commissure following tumor resection using four types of local and pedicle flaps

BackgroundThe reconstruction of through-and-through cheek defects involving the labial commissure following cancer ablation is a surgical challenge.MethodsThis study evaluated 35 patients with buccal squamous cell carcinoma (SCC) involving the labial commissure who underwent Abbe–Estlander (A-EF), folded extended supraclavicular fasciocutaneous island (SFIF), folded pectoralis major muscle (PMMF), or folded extended vertical lower trapezius island myocutaneous (TIMF) flap reconstruction of through-and-through cheek defects involving the labial commissure following radical resection.ResultsThe A-EF and SFIF groups differed significantly (P < 0.05) from the PMMF and TIMF groups in terms of tumor clinical stage and type of treatment. The inner PMMF (median 6.3 × 4.5) and TIMF (median 9.8 × 6.7) skin paddle dimensions were larger than those of the A-EF (median 1.8 × 2.2) and SFIF (median 5.5 × 4.3) groups (P < 0.05). The outer PMMF (median 6.3 × 6.6) and TIMF (median 9.8 × 13.2) dimensions were larger than those of the A-EF (median 1.8 × 3.8) and SFIF (median 5.5 × 4.6) groups (P < 0.05). The esthetic results, orbicularis oris function, and speech function were significantly (P < 0.05) better in the A-EF group than in the SFIF, PMMF, and TIMF groups. The patients were followed for 6–38 months (median 26.8, 25.0, 22.1, and 20.8 months in the A-EF, SFIF, PMMF, and TIMF groups, respectively). At the final follow-up, 4 (80.0%) patients in the A-EF, 7 (87.5%) in the SFIF, 5 (55.6%) in the PMMF, and 5 (38.4%) in the TIMF groups were alive with no disease; 1 (20.0%), 1 (22.2%), 2 (22.2%), and 4 (30.8%) patients, respectively, were alive with disease; and 2 (22.2%) patients in the PMMF and 4 (30.8%) in the TIMF group had died of local recurrence or distant metastases at between 9 and 38 months. There was a significant survival difference in the A-EF and SFIF groups compared with the PMMF and TIMF groups (P < 0.05).ConclusionsThe A-EF is suitable for reconstructing defects of clinical stage II disease; the SFIF for clinical stage II or III disease; the PMMF for clinical stage III or IV; and the TIMF for clinical stage rCS III or rCS IV disease.

Factors Influencing Locoregional Recurrence and Disease-Free Survival in Buccal Mucosal Squamous Cell Carcinoma

Oral cancers are the most common malignancy affecting Indian population with buccal mucosa being the frequent subsite. This study is to evaluate the histopathological factors influencing locoregional recurrence (LRR) and disease-free survival (DFS) in buccal mucosal squamous cell carcinoma (BSCC). One hundred and twenty patients treated surgically for BSCC with a curative intend between January 2014 and December 2015 were retrospectively analyzed. Histopathological factors like tumor stage, grade of differentiation, tumor front, skin involvement, bone involvement, depth of invasion, perineural invasion, lymphovascular emboli, primary resection margin in frozen section, nodal stage, extracapsular extension, and lymph node ratio were analyzed and compared for LRR and DFS. With a median follow-up of 41 months, LRR occurred in 34 patients (28.3%) and a 2-year DFS was 75.8%. Multivariate analysis identified that the factors that independently influenced the LRR were pathological nodal stage (p < 0.0001) and primary resection margin in frozen section (p < 0.0001). A single neck node involvement increases risk by 6.8 times for LRR compared to no nodal involvement (95% CI 2.897–15.888, p < 0.0001). Frozen section studies on primary tumor excision margin showed that close margin had 2.3 times chance of LRR (95% CI 1.020–5.035, p < .045) and involved margin showed 20.9 times risk of LRR compared to clear margin(95% CI 6.529–67.021, p < 0.0001). Primary resection margin on frozen section and pathological nodal status are the most important factors influencing LRR and DFS. This study highlights importance of aggressive treatment and close follow-up even with a single node involvement and when frozen section margin clearance is less than 5 mm.

Rapid in-field failures following adjuvant radiation for buccal squamous cell carcinoma.

Squamous cell carcinoma originating in the buccal mucosa and retromolar trigone (RMT) have historically poor outcomes. Difficulties in discriminating tumor origin often result in these subsites being combined in surgical and pathological reports. We aimed to determine if making this anatomical distinction has implications for treatment design and clinical outcomes. Retrospective case series. We identified 27 tumors from either the buccal mucosa patients or RMT patients who underwent surgery followed by radiation. For patients who developed a local failure, we fused the pretreatment imaging, simulation computed tomography, and follow-up imaging to determine the location of failures relative to the radiation field. We calculated the 2-year locoregional control and 2-year disease-free survival. The median time from surgery to radiation was 50 days (range, 32-133 days). The 2-year locoregional control for buccal mucosa versus RMT, respectively, were 35.9% versus 68.4% (P = .252). The 2-year disease-free survival rates were 32.7% versus 68.4%, respectively (P = .196). The median times to failure were 12.00 months (range, 4.9-115.0 months) versus 18.5 months (range, 4.5-61.0 months), respectively. All buccal mucosa failures occurred within the high-dose planning target volume, with a median dose of 60 Gy within the failure region. Following locoregional failure, 10 of the 12 patients have died, with a median time from local failure to death of 3.6 months (range, 1-17.6 months). Squamous cell carcinomas of the buccal mucosa appear to have a poor prognosis characterized by rapid in-field failure. Therefore, differentiating tumor origin may be important for prognostication and treatment. 3 Laryngoscope, 130:413-417, 2020.

Behavior of Buccal Mucosal Squamous Cell Carcinoma: A Retrospective Study of 53 Carcinomas of This Anatomical Region.

The main aim of the present report is to study the pattern of distribution of cervical metastasis in buccal mucosa cancer and to discuss the various therapeutic options available. Fifty-three patients with squamous cell carcinoma of the buccal mucosa treated with tumorectomy and selective neck dissection were included in the study. We also studied the relationship between specific pathological features and overall survival. Level Ib was the most affected level, followed by level IIa. T stage, N stage, N involvement tumor thickness, extracapsular spread (ECS), and vascular invasion were associated with poorer outcomes regarding overall survival ( p < 0.001). Carcinoma of the buccal mucosa should be treated aggressively from the early stages. A large tumorectomy of the primary tumor is required to reduce the number of local recurrences. Moreover, we recommend performing a supraomohyoid neck dissection even in cT1N0 if there is a suspicion that the tumor thickness may be greater than 0.4 cm. The high risk of local recurrence obliges protection of the neck from a future cervical recurrence even in T1 small tumors. This could reduce the risk of cervical involvement during the follow-up and improve overall survival rates.

Postoperative physiotherapy management for complications related to cancer of buccal mucosa (head and neck cancer)

Buccal mucosa squamous cell carcinoma is rare and is considered as an aggressive form of oral cavity cancer. It is also associated with a high rate of local regional recurrence and is seen commonly in people who are habitual tobacco chewers and/or smokers with or without alcohol intake. This case report represents a 40-year-old, moderately built female of buccal mucosa carcinoma who visited the surgical oncology department with involvement of the underlying skin and underwent commando surgery with complaints of pain, restriction of movements at the operated site, chest pain and breathlessness, swelling of left side of cheek, and limited mouth opening as postoperative complications, highlighting on the postsurgical physiotherapy management in commando surgery for buccal mucosa carcinoma and alleviating symptoms that were apparent with improvement in the quality of life of the patient.

Pathway based prognostic gene expression profile of buccal and gingivo-buccal oral squamous cell carcinoma in smokeless tobacco chewers.

The objective was to study comprehensive mRNA expression profiles of buccal mucosa oral squamous cell carcinoma (OSCC-BM) and gingivo-buccal OSCC (OSCC-GB) in smokeless tobacco chewers to understand the biological behavior of OSCC at these specific sites and identify diagnostic and prognostic markers. High throughput RNA sequencing transcriptome of fresh buccal mucosa (4 samples) and gingivo-buccal (4 samples) OSCC with normal oral mucosa (3 samples) was performed on Illumina NextSeq500 paired end sequencing with 75x2bp. In the comparison between OSCC and normal, there were 402 differentially expressed genes (DEGs); between OSCC-BM and normal, there were 467 DEGs; and between OSCC-GB and normal oral tissue, there were 608 DEGs. Pathway-based analysis of gene expression was done. The inflammation mediated by chemokine and cytokine signaling pathway had the maximum gene hits. FZD2 and its interactions with the cadherins have a role in invasion and metastasis. immunosurveillance is evident in OSCC-GB with the downregulation of CADM1.

What Is the Role of Elective Neck Dissection in the Management of Patients With Buccal Squamous Cell Carcinoma and Clinically Negative Neck?

Buccal squamous cell carcinoma (BSCC) is rare in the United States. Given its location, few anatomic barriers to spread exist and it has been found to have a high locoregional recurrence rate. The role of elective neck dissection (END) in patients with clinically negative neck (N0) is not clear. This study aims to answer the following research question: Among patients with N0 BSCC, does END improve locoregional control rates, distant metastasis rates, and 2- and 5-year survival rates? A retrospective cohort study was conducted. The sample included patients who received a diagnosis of BSCC. The primary predictor variable was END status (yes or no). Five institutions participated between June 2001 and June 2011: University of Washington, University of Michigan, University of Tennessee, North Memorial Oral and Maxillofacial Surgery in Minnesota, and Head and Neck Surgical Associates (Portland, OR). The primary outcome variable was locoregional recurrence. Secondary outcome variables were distant metastasis and 2- and 5-year survival rates. Other variables collected were demographic characteristics, initial operation, adjuvant therapy, clinical and pathologic data, and staging. Kaplan-Meier and Cox proportional hazards statistics were computed. The sample was composed of 98 patients with clinical N0 BSCC. The mean age was 66years (range, 30-88years), and 54% were men.Of the patients, 74 (76%) underwent END. The locoregional recurrence-free rate was 61% for END versus 38% for no END (P=.042). The distant metastasis rate was 4% for END versus 9% for no END. The 2- and 5-year disease-free survival rates were 91% and 75% (P=.042), respectively, for END and 85% and 63% (P=.019), respectively, for no END. END had a therapeutic effect, as evidenced by a lower locoregional recurrence rate, lower distant metastasis rate, and improved 2- and 5-year survival rates.

Patterns of Care and Outcomes in Patients with Squamous Cell Carcinoma of the Buccal Mucosa

Primary buccal mucosa squamous cell carcinoma represents approximately 2% of all oral cavity cancer cases in the United States annually. Resection, followed by adjuvant therapy if indicated, is the preferred management, with definitive radiation or chemoradiation reserved for situations where surgery isn’t feasible. The purpose of this study was to examine patterns of care and outcomes for squamous cell carcinoma of the buccal mucosa. Using the National Cancer Data Base (NCDB) we identified 5,786 patients with primary buccal mucosa squamous cell carcinoma diagnosed between 2004-2014. Patients who lived less than 3 months from diagnosis or who had stage 0 or IVC disease were excluded. Patient and treatment factors were compared between patients who received surgery alone (S), postoperative radiation therapy (S+RT), postoperative chemoradiation (S+CRT) or definitive chemoradiation (CRT) using the Chi-square test. Univariate and multivariate Cox proportional hazards regression models were used for covariate survival analysis. The final cohort analysis included 2,570 patients. Median age and median follow-up for the cohort were 69 years and 44 months, respectively. 1068 patients had stage I/II disease and 936 had stage III-IVB. 1,468 (57.1%) patients received surgery alone, 605 (23.5%) received S+RT, 300 (11.7%) S+CRT, and 197 (7.7%) definitive CRT. Median total radiation dose was 64 Gy (IQR 60 – 70) for those that received RT. The 3-year overall survival of the entire cohort was 71.8%, 58.4%, 52.6%, and 35.8% for the S, S+RT, S+CRT, and CRT arms, respectively. The 3-year survival by stage were 71.3% (I-II), 54.5% (III) and 38.7% (IVA-IVB). Charlson/Deyo score of 32 (HR 1.65, 95% CI 1.16-2.30, p<0.001), overall stage III-IVB disease (HR 1.85, 95% CI 1.48-2.30, p<0.001), presence of ECE (HR 1.43, 95% CI 1.12-1.83, p=0.004) were associated with worse survival on multivariate analysis. Higher number of neck nodes removed were associated with improved survival (HR 0.65-0.69, p<0.05). Nearly 60% of buccal mucosal cancers present with stage III-IVB disease. Consistent with national guidelines, more than 90% of patients were treated with surgery with or without adjuvant therapy rather than definitive chemoradiation. Patients presenting with stage IVA-IVB disease have a very poor prognosis, with a 3 year overall survival of 38%.

Rapid In-Field Failures Following Adjuvant Radiation for Buccal Squamous Cell Carcinoma

Squamous cell carcinoma originating in the buccal mucosa and retromolar trigone (RMT) have historically poor outcomes. Difficulties in discriminating tumor origin often result in these subsites being combined in surgical and pathological reports. We aimed to determine if making this anatomical distinction has implications for treatment design and clinical outcomes. Following institutional review board approval, we reviewed all of our oral cavity cases from the last 10 years and identified 27 tumors from either the buccal mucosa or RMT which underwent surgery with reconstruction followed by radiation therapy. We reviewed all pre-operative imaging and examination reports to accurately determine the site of origin. For patients who developed a local failure, we fused the pre-treatment imaging, simulation CT, and follow up imaging to determine the location of failures relative to the radiation field. All recurrences were biopsy proven. We used the Kaplan-meier method to calculate 2-year locoregional control and 2-year disease free survival. Patient characteristics can be found in table 1. The median prescribed radiation dose was 60 Gy and the median time from surgery to radiation was 50 (32-133) days. The 2-year locoregional control rates for buccal mucosa versus RMT respectively were 32.7% versus 68.4%. The 2-year disease free survival rates were 35.9% versus 68.4%. The median times to failure were 12.00 (4.9-115.0) months versus 18.5 (4.5-61.0) months. All buccal mucosa failures occurred within the high dose PTV with a median dose of 60 Gy within the failure region. Following locoregional failure 10 of the 12 patients have died, with a median time from local failure to death of 109 (4-529) days. Squamous cell carcinomas of the buccal mucosa have a dismal prognosis characterized by rapid in field failure. By contrast, RMT cancers may have more favorable outcomes. Therefore, differentiating tumor origin is important for prognostication and treatment. For buccal cancers, interval diagnostic imaging before radiation and treatment intensification should be explored.Abstract MO_6_2507; Table 1Patient CharacteristicsCharacteristicBuccal n=13 (%)RMT n=14 (%)Median Age (y)5857Male10 (77)12 (86)Female3 (23)2 (14)T stageT13 (23)2 (14)T24 (31)2 (14)T301 (7)T4a6 (46)8 (57)T4b01 (7)N stageN09 (69)5 (36)N12 (15)2 (14)N2a00N2b2 (15)7 (50)Overall StageI2 (15)0II4 (31)1 (7)III02 (14)IVA7 (54)10 (71)IVB01 (7)Positive Margin4 (31)8 (57)PNI4 (31)6 (43)LVSI1 (8)6 (43)ECE1 (8)5 (36)Chemo6 (46)7 (50)RT Dose (Median)6066 Open table in a new tab

Salvage surgery versus primary surgery for buccal mucosal squamous cell carcinoma and the need for neck dissection

Salvage surgery versus primary surgery for buccal mucosal squamous cell carcinoma and the need for neck dissection

Desmoglein 3 – Influence on oral carcinoma cell migration and invasion

Desmoglein 3 (Dsg3) is an adhesion receptor in desmosomes, but its role in carcinoma cell migration and invasion is mostly unknown. Our aim was to quantitatively analyse the motion of Dsg3-modified carcinoma cells in 2D settings and in 3D within tumour microenvironment mimicking (TMEM) matrices. We tested mutant constructs of C-terminally truncated Dsg3 (∆238 and ∆560), overexpressed full-length (FL) Dsg3, and empty vector control (Ct) of buccal mucosa squamous cell carcinoma (SqCC/Y1) cells. We captured live cell images and analysed migration velocities and accumulated and Euclidean distances. We compared rodent collagen and Matrigel® with human Myogel TMEM matrices for these parameters in 3D sandwich, in which we also tested the effects of monoclonal antibody AK23, which targets the EC1 domain of Dsg3. In monolayer culture, FL and both truncated constructs migrated faster and had higher accumulated distances than Ct cells. However, in the 3D assays, only the mutants invaded faster relative to Ct cells. Of the mutants, the shorter form (Δ238) exhibited faster migration and invasion than Δ560 cells. In the Transwell, all of the cells invaded faster through Myogel than Matrigel® coated wells. In 3D sandwich, AK23 antibody inhibited only the invasion of FL cells. We conclude that different experimental 2D and 3D settings can markedly influence the movement of oral carcinoma cells with various Dsg3 modifications.

Effects of far infrared radiation by isotropic high-density carbon on the human oral mucosa

ObjectivesWound healing of the oral mucosal epithelium through the application of far infrared radiation emitted by isotropic high-density carbon was investigated in order to clarify the preventive and therapeutic effects of isotropic high-density carbon on oral mucosal injury. Materials and methodsA carbon massager with an isotropic high-density carbon tip was used. Far infrared radiation was applied to the human buccal mucosal squamous cell carcinoma cell line, HO-1-N-1 using a carbon massager, and cell growth factors and heat shock protein levels were measured using real-time RT-PCR and ELISA. Far infrared radiation was applied to oral mucosal injury in SD rats over time using the carbon massager, and its effects were examined by HE staining and immunostaining. The immunostaining positive rate was measured and analyzed using image analysis software. ResultsFar infrared radiation induced stronger mRNA expression and higher HSP27 and HSP70 protein levels on real-time RT-PCR and ELISA than in the control group. The far infrared radiation of oral mucosal injury in rats induced strong positive reactions, and positive rates for Ki67, HSP27, and HSP70 were higher than those in the control group. ConclusionsThe treatment of oral mucosal injury with far infrared radiation emitted by isotropic high-density carbon appears to have promoted heat shock protein production and induced regenerative reactions more strongly than in the control group.

Tripaddled Anterolateral Thigh Flap for the Reconstruction of Extensively Full-Thickness Cheek Defects by Stacking Two Skin Paddles as Kiss Pattern.

Extended anterolateral thigh (ALT) flap can provide a large amount of skin to reconstruct the extensively full-thickness defects of cheek. However when the width of 1 skin paddle exceeds 8 cm, it always results in that the donor site cannot be closed primarily and need to be covered by split-thickness skin grafting, which delivers lots of impacts on the functional and cosmetic outcome of the thigh. The aim of this study was to introduce the authors' modification of stacking 2 skin paddles of the tripaddled ALT flap to reconstruct the extensive full-thickness defects in the cheek after the radical ablasion of advanced buccal squamous cell carcinoma. Ten patients of advanced buccal squamous cell carcinoma between March 2014 and December 2016 were enrolled in the authors' hospital. All the patients were received the soft-tissue reconstructions for the extensively full-thickness cheek defects by using the tripaddled ALT chimeric flaps. Among 3 skin paddles, the distal paddle was used to reconstruct the inner mucosa defect, and the other 2 large skin paddles were stacked side by side for outer mega cheek defect. The mean area of the intraoral defect was 32.2 cm and the mean area of the extraoral defect was 106.34 cm. The mean width of the outer skin defect was 9.5 cm. All the flaps survived and all the donor sites were closed primarily. So, stacking 2 skin paddles of a tripaddled ALT flap as a kiss pattern is a novel modification on conventional flap design to provide customized coverage for extensive and full-thickness buccal defects while minimizing donor-site morbidity.