Management of the neck in T1 and T2 buccal squamous cell carcinoma

O. A. Nicholson*, C. G.F. Van Lanschot, B. N. van den Besselaar, Y. Aaboubout, T. Iseli, J. A.U. Hardillo, H. Mast, L. McDowell, S. Koljenović, S. Kranz, R. J. Baatenburg de Jong, S. Keereweer, D. Wiesenfeld

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Scopus)

Abstract

Buccal squamous cell carcinoma (SCC) appears to behave more aggressively than other oral subsites, in particular with regards to regional disease at presentation and regional recurrence. Adequate management of the neck is of the utmost importance but is still the subject of debate. An international multicentre retrospective review of 101 patients treated for T1–T2 buccal SCC was performed. Twenty-four were staged clinical node positive (cN+) and underwent therapeutic neck dissection, while 77 were node negative (cN0), with 32 undergoing elective neck dissection (END), with an occult nodal metastasis rate of 28.1%. Depth of invasion (DOI) < 4 mm was associated with a significantly lower rate of cervical nodal metastasis (87.5% versus 12.5%; P = 0.033). END demonstrated a non-significantly lower regional recurrence rate compared to observation (6.3% versus 8.9%, P = 0.670). Regional recurrence was more common in pN+ (24%) and undissected cases (8.9%) than in pN0 patients (0%) (P = 0.011) and was associated with DOI > 5 mm (P = 0.002). Regional recurrence resulted in a reduction in survival (24 versus 93 months, P < 0.001). In the pT2cN0 group, END improved survival (123 versus 26 months, P = 0.009). It is suggested that END be performed in cT2N0 buccal SCC, particularly for tumours with DOI > 4 mm.

Original languageEnglish
Pages (from-to)259-267
Number of pages9
JournalInternational Journal of Oral and Maxillofacial Surgery
Volume53
Issue number4
Early online date26 Aug 2023
DOIs
Publication statusPublished - Apr 2024

Bibliographical note

Publisher Copyright:
© 2023 International Association of Oral and Maxillofacial Surgeons

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