Journal of the Chinese Medical Association
Volume 70, Issue 4 , Pages 164-170, April 2007

Clinicopathologic Evaluation of Prognostic Factors for Squamous Cell Carcinoma of the Buccal Mucosa

  • Cheng-Hui Huang

      Affiliations

    • Department of Otolaryngology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
    • ,
  • Sau-Tung Chu

      Affiliations

    • Department of Otolaryngology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Sau-Tung Chu, Department of Otolaryngology, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan, R.O.C.
    • ,
  • Luo-Ping Ger

      Affiliations

    • Laboratory of Epidemiology and Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
    • ,
  • Yu-Yi Hou

      Affiliations

    • Department of Otolaryngology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
    • Fooyin University Hospital, Ping-Tong, Taiwan, R.O.C.
    • ,
  • Chih-Pei Sun

      Affiliations

    • Laboratory of Epidemiology and Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.

Received 6 September 2006; accepted 8 March 2007.

Article Outline

Background

The purpose of this research was to evaluate the prognostic significance of clinicopathologic variables on the survival rate for squamous cell carcinoma of the buccal mucosa (BMSCC). We analyzed the outcomes of surgical therapy for this aggressive cancer and compared these results with those in the literature.

Methods

We reviewed the medical charts of 172 patients treated in our institution between 1990 and 2005. There were 22 patients excluded from our studies: 20 patients with advanced tumors who received no treatment or palliative treatment, and 2 patients who had received preoperative radiotherapy (RT). The remaining 150 patients were treated with surgeries and among them, 56 patients had undergone postoperative RT. The influence of clinicopathologic factors on the survival rate was analyzed with the Kaplan-Meier method and log-rank test. Multivariate analysis was assessed with Cox's regression model.

Results

There were 148 males and 2 females, with a mean age of 53.5 years. The prevalence rate of habitual betel quid chewing documented in charts among 113 patients was 75%. The 5-year overall survival rate and disease-specific survival rate for all patients were 64% and 69%, respectively. For patients with stages I, II, III, and IV disease, the 5-year disease-specific survival rates were 90%, 77%, 52%, and 47%, respectively (p< 0.001). According to the multivariate analysis, the pathologic staging and histologic grading of the tumor were independently the important prognostic factors affecting survival rate. There were 80 patients who developed locoregional recurrence in lymph nodes in the follow-up diagnoses. Distant metastases occurred in 14 patients, with 11 of them also having locoregional recurrence. The distant metastases were found in the lungs (8/14), T-spine (3/14), liver (2/14) and brain (1/14).

Conclusion

Pathologic stage and histologic grade are the most important prognostic factors.

Key Words:  buccal squamous cell carcinoma , survival , treatment outcome

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References 

  1. Nair MK , Sankaranarayanan R , Padmanabhan TK . Evaluation of the role of radiotherapy in the management of carcinoma of the buccal mucosa . Cancer . 1988;61:1326–1331
  2. Fang FM, Leung SW, Huang CC, Liu YT, Wang CJ, Chen HC, et al  Combined-modality therapy for squamous carcinoma of the buccal mucosa: treatment results and prognostic factors . Head Neck . 1997;19:506–512
  3. Chen YK , Huang HC , Lin LM , Lin CC . Primary oral squamous cell carcinoma: an analysis of 703 cases in southern Taiwan . Oral Oncol . 1999;35:173–179
  4. Iyer SG , Pradhan SA , Pai PS , Patil S . Surgical treatment outcomes of localized squamous carcinoma of buccal mucosa . Head Neck . 2004;26:897–902
  5. Lin CS, Jen YM, Cheng MF, Lin YS, Su WF, Hwang JM, et al  Squamous cell carcinoma of the buccal mucosa: an aggressive cancer requiring multimodality treatment . Head Neck . 2006;28:150–157
  6. Liao CT, Wang HM, Ng SH, Yen TC, Lee LY, Hsueh C, et al  Good tumor control and survivals of squamous cell carcinoma of buccal mucosa treated with radical surgery with or without neck dissection in Taiwan . Oral Oncol . 2006;42:800–809
  7. Lo WL , Kao SY , Chi LY , Wong YK , Chang RC . Outcomes of oral squamous cell carcinoma in Taiwan after surgical therapy: factors affecting survival . J Oral Maxillofac Surg . 2003;61:751–758
  8. Vegers JW , Snow GB , van der Waal I . Squamous cell carcinoma of the buccal mucosa: a review of 85 cases . Arch Otolaryngol . 1979;105:192–195
  9. Department of Health  . Cancer Registry Annual Report in Taiwan Area, 2002 . Taipei: The Executive Yuan, Taiwan ROC; 2002;
  10. Ko YC , Chiang TA , Chang SJ , Hsieh SF . Prevalence of betel quid chewing habit in Taiwan and related sociodemographic factors . J Oral Pathol Med . 1992;21:261–264
  11. Lin YS , Jen YM , Wang BB , Lee JC , Kang BH . Epidemiology of oral cavity cancer in Taiwan with emphasis on the role of betel nut chewing . ORL J Otorhinolaryngol Relat Spec . 2005;67:230–236
  12. Lee JJ, Jeng JH, Wang HM, Chang HH, Chiang CP, Kuo YS, et al  Univariate and multivariate analysis of prognostic significance of betel quid chewing in squamous cell carcinoma of buccal mucosa in Taiwan . J Surg Oncol . 2005;91:41–47
  13. Chen JW , Shaw JH . A study on betel quid chewing behavior among Kaohsiung residents aged 15 years and above . J Oral Pathol Med . 1996;25:140–143
  14. Kuo MY , Jeng JH , Chiang CP , Hahn LJ . Mutations of Ki-ras oncogene codon 12 in betel quid chewing-related human oral squamous cell carcinoma in Taiwan . J Oral Pathol Med . 1994;23:70–74
  15. Rodgers GK , Myers EN . Surgical management of the mass in the buccal space . Laryngoscope . 1988;98:749–753
  16. Bloom ND , Spiro RH . Carcinoma of the cheek mucosa: a retrospective analysis . Am J Surg . 1980;140:556–559
  17. Pop LA, Eijkenboom WM, de Boer MF, de Jong PC, Knegt P, Levendag PC, et al  Evaluation of treatment results of squamous cell carcinoma of the buccal mucosa . Int J Radiat Oncol Biol Phys . 1989;16:483–487
  18. Strome SE, To W, Strawderman M, Gersten K, Devaney KO, Bradford CR, et al. Squamous cell carcinoma of the buccal mucosa . Otolaryngol Head Neck Surg . 1999;120:375–379
  19. Sieczka E, Datta R, Singh A, Loree T, Rigual N, Orner J, et al  Cancer of the buccal mucosa: Are margins and T-stage accurate predictors of local control? . Am J Otolaryngol . 2001;22:395–399
  20. Chhetri DK , Rawnsley JD , Calcaterra TC . Carcinoma of the buccal mucosa . Otolaryngol Head Neck Surg . 2000;123:566–571
  21. Diaz EM , Holsinger FC , Zuniga ER , Roberts DB , Sorensen DM . Squamous cell carcinoma of the buccal mucosa: one institution's experience with 119 previously untreated patients . Head Neck . 2003;25:267–273
  22. Lee KH , Veness MJ , Pearl-Larson T , Morgans GJ . Role of combined modality treatment of buccal mucosa squamous cell carcinoma . Aust Dent J . 2005;50:108–113
  23. Mshra RC , Singh DN , Mishra TK . Post-operative radiotherapy in carcinoma of buccal mucosa, a prospective randomized trial . Eur J Surg Oncol . 1996;22:502–504
  24. Dixit S , Vyas RK , Toparani RB , Baboo HA , Patel DD . Surgery versus surgery and postoperative radiotherapy in squamous cell carcinoma of the buccal mucosa: a comparative study . Ann Surg Oncol . 1998;5:502–510
  25. Greene FL, Page DL, Fleming ID, Fritz AG, Balch CM, Haller DG, et al. American Joint Committee on Cancer. AJCC Cancer Staging Manual . 6 edition. New York: Springer-Verlag; 2002;
  26. Ildstad ST , Bigelow ME , Remensnyder JP . Clinical behavior and results of current therapeutic modalities for squamous cell carcinoma of the buccal mucosa . Surg Gynecol Obstet . 1985;160:254–258
  27. Urist MM , O'Brien CJ , Soong SJ , Visscher DW , Maddox WA . Squamous cell carcinoma of the buccal mucosa: analysis of prognostic factors . Am J Surg . 1987;154:411–414
  28. Yang YH , Chen HR , Tseng CH , Shieh TY . Prevalence rates of areca/betel quid chewing in countries of Taiwan . Taiwan J Oral Med Health Sci . 2002;18:1–16
  29. Willen R , Nathanson A , Moberger G , Anneroth G . Squamous cell carcinoma of the gingival: histological classification and grading of malignancy . Acta Otolaryngol . 1975;79:146–154
  30. Su HH , Chu ST , Hou YY , Cheng KP , Chen CJ . Spindle cell carcinoma of the oral cavity and oropharynx: factors affecting outcome . J Chin Med Assoc . 2006;69:478–483
  31. Haughey BH , Gates GA , Arfken CL , Harvey J . Meta-analysis of second malignant tumors in head and neck cancer: the case for an endoscopic screening protocol . Ann Otol Rhinol Laryngol . 1992;101:105–112
  32. Lee G , Wong YK , Chang YL , Chang CS . Metastasis in oral squamous cell carcinoma . J Chin Med Assoc . 1991;48:445–450

PII: S1726-4901(09)70351-X

doi:10.1016/S1726-4901(09)70351-X

Journal of the Chinese Medical Association
Volume 70, Issue 4 , Pages 164-170, April 2007

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