title: Tumor Thickness: A predictor of nodal disease in early squamous cell carcinomas of buccal mucosa.
abstract: Squamous cell carcinomas of buccal mucosa is one the highest number of malignancies seen in the Southeast Asian region. It is related to chewing a combination of tobacco mixed with betel leaves, areca nut, and lime shell called quid. As it is most commonly due to substance abuse and affects younger population, it has tremendous economical and social consequences. Surgery is the most successful modality of management in these patients. The surgery involves wide excision of the diseased mucosa and neck dissection. Neck dissection is associated with certain morbidities, but is routinely practiced in some centers like ours. We have attempted to evaluate the occurrence of the nodal disease in relation to the thickness of the tumor in cases of early cancers of buccal mucosa (stage I and II). We have used ultrasound of the lesion as our modality to assess the tumor thickness preoperatively. AJCC 7th edition was used to assess the clinical and pathological stage of the disease. We have studied 52 patients of early buccal mucosal squamous cell carcinoma, and we observed that tumors thicker than 7mm (p-0.05) have highest co-relation with nodal metastases. This study also recommends that neck dissection should be prophylactically performed for tumors thicker than 4mm. Tumor characteristics such as grade, perineural invasion, and lymphatic invasion should be considered as predictors for early nodal involvement.
authors.affiliation: Dept. of Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat. India.
authors.forename: G
authors.initials: G
authors.lastname: Deshpande
authors.affiliation: Dept. of Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat. India.
authors.forename: S
authors.initials: S
authors.lastname: Das