1990 Volume 36 Issue 12 Pages 2835-2848
Foully-three cases of the buccal niucosal carcinoma were reviewed. The average age of the patients was 65.5 years old indicating many of them is in rather older ages. Most of the cases were squamous cell carcinoma.
About half of the cases were in T2, 79% of the cases were in NO, tikl all eases were in MO by TNM classification.
Thirty-nine treated cases were studied for further clinical analysis.
Initial treatments were consisted of radiotherapy alone in 21 cases, combination therapy by both radiation and surgery in 5 cases and surgery alone in 13 cases and the primary tumor control rate of each therapy was 61.9%, 60.0%, and 61.5% respectively. All eight cases of T4 lesion showed a local recurrence.
Regional lymph node metastases were observed in 38.5% with 8 cases found at the initial examination and 7 eases later on. Neck dissection was performed in 11 c.tses, but a final control of the regional metastases was obtained in 36.4% of the patients who had regional metastases. The tumor recurrence rate was analyzed with a histological pattern of invasion in 27 cases of squamous cell carcinoma.
Recurrence in the primary sites was inevitable in 4C and 4D types, and the average day of disease-free survival in these types was very short. The five years cummurative survival rate of all treated patients was 50.6% by Kaplan-Meier's method. No five years survived ease was obtained in patients with T 4 lesions, positive regional metastases, 4C or 4D types in mode of invasion.
Prognostic factors of carcinoma of the buccal mucosa were discussed. T 4 lesion, invasive type lesion originating from the retromolar area, 4 C or 4 U type in mode of invasion were considered to suggest poor prognosis. A wide combined excision including elective neck dissection is recommended for further improvement of the cases indicating these poor prognostic factors.
