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Compartmental Clearance of Infratemporal Fossa for T4b Carcinoma of Buccal Mucosa/Alveolus: Clinical Outcomes

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Abstract

T4 b carcinoma of oral cavity has poor outcomes. The aim for analysis is to evaluate the clinical outcomes with infratemporal fossa clearance for stage T4b carcinoma of oral cavity. Fifty four patients out of maintained data of 528 patients of oral cavity carcinoma were evaluated for current retrospective analysis. All had T4b disease on imaging and underwent bite composite resection with ITF clearance. The median age of the cohort was 52 years. At last follow-up, 28 patients were alive. Twenty two patients had loco-regional recurrence (ITF recurrence 7), and 16 patients had distant metastasis.

At median follow-up of 29 months, 2-year loco-regional control, DFS and OS were 52%, 54% and 54%, respectively. Perineural invasion, pathological tumour stage, node positive and ITF tissue involvement were associated with poor oncological outcomes. ITF clearance is feasible in clinical practice and provides curative option for this group.

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Abbreviations

GBC:

Gingivo-buccal sulcus complex

AJCC:

American Joint Committee on Cancer

ITF:

Infra-temporal fossa

PMF:

Pterygomaxillary fissure

SPSS:

Statistical Package for the Social Sciences

DFS:

Disease-free survival

OS:

Overall survival

PNI:

Perineural invasion

References

  1. Ferlay J, Soerjomataram I, Ervik M et al (2013) GLOBOCAN 2012 v1.0, cancer incidence and mortality worldwide: IARC cancer base no. 11 [internet]. Lyon, International Agency for Research on Cancer Available at: http://globocan.iarc.fr

    Google Scholar 

  2. Pathak KA, Gupta S, Talole S, Khanna V, Chaturvedi P, Deshpande MS, Pai PS, Chaukar DA, D'Cruz AK (2005) Advanced squamous cell carcinoma of lower gingivobuccal complex: patterns of spread and failure. Head Neck 27:597–602

    PubMed  Google Scholar 

  3. Patil VM, Prabhash K, Noronha V, Joshi A, Muddu V, Dhumal S, Arya S, Juvekar S, Chaturvedi P, Chaukar D, Pai P, Kane S, Patil A, Agarwal JP, Ghosh-Lashkar S, Dcruz A (2014) Neoadjuvant chemotherapy followed by surgery in very locally advanced technically unresectable oral cavity cancers. Oral Oncol 50(10):1000–1004

    CAS  PubMed  Google Scholar 

  4. Edge S, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A (2009) AJCC cancer staging manual, 7th edn. Springer, Bangalore

    Google Scholar 

  5. Tryhus MR, Smoker WR, Harnsberger HR (1990) The normal and diseased masticator space. Semin Ultrasound CT MR 11:476–485

    CAS  PubMed  Google Scholar 

  6. Wei Y, Xiao J, Zou L (2007) Masticator space: CT and MRI of secondary tumour spread. AJR Am J Roentgenol 189:488–497

    PubMed  Google Scholar 

  7. Yousem DM, Gad K, Tufano RP (2006) Resectability issues with head and neck cancer. AJNR Am J Neuroradiol 27:2024–2036

    CAS  PubMed  Google Scholar 

  8. Agarwal JP, Nemade B, Murthy V, Ghosh-Laskar S, Budrukkar A, Gupta T et al (2008) Hypofractionated, palliative radiotherapy for advanced head and neck cancer. Radiother Oncol 89:51–56

    PubMed  Google Scholar 

  9. Corry J, Peters LJ, Costa ID, Milner AD, Fawns H, Rischin D et al (2010) The ‘QUAD SHOT’ – a phase II study of palliative radiotherapy for incurable head and neck cancer. Radiother 22:890–891

    Google Scholar 

  10. Arya S, Rane P, D’Cruz A (2012) Infratemporal fossa, masticator space and parapharyngeal space: can the radiologist and surgeon speak the same language? Int J Otorhinolaryngol Clin 4(3):125–135

    Google Scholar 

  11. Loree TR, Strong EW (1990) Significance of positive margins in oral cavity squamous carcinoma. Am J Surg 160(4):410–414

    CAS  PubMed  Google Scholar 

  12. Liao CT, Ng SH, Chang JT, Wang HM, Hsueh C, Lee LY, Tsao CK, Chen WH, Chen IH, Kang CJ, Huang SF, Yen TC (2007) T4b oral cavity cancer below the mandibular notch is resectable with a favorable outcome. Oral Oncol 43:570–579

    PubMed  Google Scholar 

  13. Liao CT, Chang JT, Wang HM, Ng SH, Hsueh C, Lee LY, Lin CH, Chen IH, Huang SF, Cheng AJ, Yen TC (2007) Survival in squamous cell carcinoma of the oral cavity: differences between pT4 N0 and other stage IVA categories. Cancer 110:564–571

    PubMed  Google Scholar 

  14. Trivedi NP, Kekatpure VD, Shetkar G et al (2015) Pathology of advanced buccal mucosa cancer involving masticator space (T4b). Indian J Cancer 52(4):611–615

    CAS  PubMed  Google Scholar 

  15. Mair MD, Nair S, Nikam S et al (2018) Impact of radical treatments on survival in locally advanced T4a and T4b buccal mucosa cancers: selected surgically treated T4b cancers have similar control rates as T4a. Oral Oncol 82:17–22

    PubMed  Google Scholar 

  16. Duprez F, Berwouts D, De Neve W et al (2017) Distant metastases in head and neck cancer. Head Neck 39(9):1733–1174

    PubMed  Google Scholar 

  17. Joshi A, Patil VM, Noronha V, Juvekar S, Deshmukh A, Chatturvedi P, Prabhash K et al (2013) Is there a role of induction chemotherapy followed by resection in T4b oral cavity cancers? Indian J Cancer 50:349–355

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Jaslok Hospital and Research Centre, Pedder Road, Mumbai, 400026, India

    Rakesh Katna, Nikhil Kalyani & Bharat Bhosale

  2. Bombay Hospital and Research Centre, Marine Lines, Mumbai, India

    Rakesh Katna, Shambhavi Singh & Bharat Bhosale

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  1. Rakesh Katna
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  2. Nikhil Kalyani
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  3. Shambhavi Singh
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  4. Bharat Bhosale
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On behalf of Mumbai Oncology Group – Head and Neck

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Correspondence to Nikhil Kalyani.

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Katna, R., Kalyani, N., Singh, S. et al. Compartmental Clearance of Infratemporal Fossa for T4b Carcinoma of Buccal Mucosa/Alveolus: Clinical Outcomes. Indian J Surg Oncol 11, 316–320 (2020). https://doi.org/10.1007/s13193-020-01057-y

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