Abstract
For the 5 years between January 2010 and December 2014 at the Department of Oral and Maxillofacial Surgery, Gunma University Hospital, oral oncologic surgery was carried out for 376 patients, of whom 3 (0.8%) had recurrence of the primary lesion even though treatment was comprehensively performed according to the oral cancer treatment protocol. No cervical recurrence was observed. Of the 3 patients, only 1 who underwent salvage surgery survived.
Comprehensive evaluation of the 3 patients showed a complex of highly aggressive pathological characteristics such as INFc (diffuse infiltration of cancer cells) and 3 or more buddings as cytobiological characteristics, a clinical stage requiring semiglossectomy of the tongue or more invasive surgery, progression to the mandibular gingiva requiring mandibular segmental resection, and cervical lymph node metastasis. Even when complete resection is confirmed based on surgical specimens at the first treatment in such patients, it might be necessary to regard them as high-risk patients for recurrence and consider postoperative treatment for both the primary lesion and neck. In addition, even when recurrence is observed, if surgery is possible, as in Patient 3, salvage might be achievable.
In both cases, an appropriate treatment plan should be formulated before surgery based on the cytobiological and clinicopathological characteristics of the tumor, and measures to prevent tumor recurrence should be taken.
