title: Advanced squamous cell carcinoma of lower gingivobuccal complex: patterns of spread and failure.
abstract: BACKGROUND
  Carcinoma of the gingivobuccal complex is commonly associated with the use of smokeless tobacco known as "quid."
  
  
  METHODS
  We conducted a retrospective chart review of 511 patients with advanced cancer of gingivobuccal complex surgically treated during 1994 to 1995. We evaluated patterns of disease failure in these patients and correlated disease-free survival with various prognostic factors.
  
  
  RESULTS
  During a median follow-up of 46 months, 159 locoregional recurrences and 11 distant metastases were detected in 148 patients. Seventy-nine percent of the recurrences appeared within 18 months of surgery, and the median survival for patients with recurrent disease was less than 4 months. Two-year and 5-year disease-free survival rates were 64% and 57%, respectively. On multivariate analysis, disease-free survival showed significant correlation with skin involvement and extracapsular spread.
  
  
  CONCLUSIONS
  Gingivobuccal cancers usually fail locoregionally. Soft tissue infiltration and extracapsular spread of nodal disease influence disease-free survival.
authors.affiliation: Head and Neck Service, Department of Surgery, Tata Memorial Hospital, Parel, Mumbai, 400012 India. kapathak@rediffmail.com
authors.forename: Kumar Alok
authors.initials: KA
authors.lastname: Pathak
authors.forename: Samir
authors.initials: S
authors.lastname: Gupta
authors.forename: Sanjay
authors.initials: S
authors.lastname: Talole
authors.forename: Vishal
authors.initials: V
authors.lastname: Khanna
authors.forename: Pankaj
authors.initials: P
authors.lastname: Chaturvedi
authors.forename: Mandar S
authors.initials: MS
authors.lastname: Deshpande
authors.forename: Prathamesh S
authors.initials: PS
authors.lastname: Pai
authors.forename: Devendra A
authors.initials: DA
authors.lastname: Chaukar
authors.forename: Anil K
authors.initials: AK
authors.lastname: D'Cruz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000556:secondary; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology*; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies