title: Outcome of per oral wide excision of T1-2 N0 localized squamous cell cancer of the buccal mucosa--analysis of 156 cases.
abstract: OBJECTIVE
  The purpose of the study was to study the outcomes of per oral wide excision of early T1-2 N0 squamous cell cancer of buccal mucosa.
  
  
  METHODS
  This is a retrospective study of early and localized squamous cell cancer of the buccal mucosa treated with peroral wide excision at a tertiary-care hospital.
  
  
  RESULTS
  A total of 156 patients were analyzed. One hundred ten patients (70.5%) had no recurrence, whereas 15 (9.6%) had a local recurrence, 24 (15.4%) had regional metastasis, three (1.9%) had locoregional recurrence, and four (2.6%) developed second primary tumors over a median follow-up of 48 months. Most patients with local recurrences (14 patients, 93.3%) and regional metastases (24 patients, 100%) could be salvaged with treatment. In contrast, all three cases with locoregional could not be salvaged. Most of the cases with recurrences, 36 (78%) in this study group, occurred within 2 years of primary treatment. Out of 143 cases with a habit of tobacco/beetel quid chewing, premalignancy was seen in 62 (43.4%) cases, showing a statistically significant association with P-value of 0.012. Fifteen (21.4%) cases with stage T2 developed regional neck nodes, while only 9 (10.5%) cases with stage T1 developed regional neck nodes with P-value of 0.032. Three-year overall survival rate and disease-free survival rates were 91.7% and 70.5%, respectively.
  
  
  CONCLUSIONS
  Peroral wide excision seems to be an adequate procedure for T1-2N0 localized squamous cancer of buccal mucosa. Prophylactic selective neck dissection should be considered in only T2 N0 cases as only T stage of the disease could be significantly correlated with the development of the metastatic neck nodes.
authors.affiliation: Department of Surgical Oncology, Prince Aly Khan Hospital, Mumbai, Maharashtra, India. drahhakim@gmail.com
authors.forename: Arsheed H
authors.initials: AH
authors.lastname: Hakeem
authors.forename: Sultan A
authors.initials: SA
authors.lastname: Pradhan
authors.forename: Jagadish
authors.initials: J
authors.lastname: Tubachi
authors.forename: Rajan
authors.initials: R
authors.lastname: Kannan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology* / Q000601:surgery; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult