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Outcome of Treatment in Locally Advanced Upper Alveolar Carcinoma Extending to Infra-temporal Fossa

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Abstract

Squamous cell carcinoma of oral cavity has a high prevalence in our region. Upper alveolar cancers are uncommon but present with locally advanced disease extending to infra temporal fossa. The outcome of treatment in these tumors is poor. Surgery followed by adjuvant therapy is the mainstay of treatment. We are presenting a retrospective analysis of outcome of treatment in 20 patients with locally advanced (T4b) upper alveolar carcinoma treated by infra-structure maxillectomy with compartment resection of infra-temporal fossa and neck dissection followed by adjuvant radiotherapy or radiotherapy with chemotherapy. Study period was from 2013 to 2018. Minimum follow up was 12 months and mean follow up 30 months. 12 patients are alive and disease free, 6 patients had local recurrence and 2 patients had regional recurrence with one having pulmonary metastasis. We observed that positive or close margins (< 5 mm after formalin fixation) predisposed to early recurrence. Erosion of pterygoid plates was a poor prognostic factor. Cervical lymph node metastasis occurred late in disease, but carried poor prognosis. Compartment resection of infra temporal fossa gave better outcome compared to other studies which reported outcome of treatment in upper alveolar cancers.

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Acknowledgements

We acknowledge the contribution of Dr. Manjunath G.N., Professor in Radiation Oncology, Sri Devaraj Urs Medical College, Kolar, India for his contribution in Adjuvant treatment of all the subjects included in this study.

Funding

There was no funding by any organisation or source for this study.

Author information

Correspondence to S. M. Azeem Mohiyuddin.

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Conflict of interest

There is no conflict of interest among the authors.

Ethical Approval

Institutional ethical committee clearance (SDUMC/KLR/IEC/85/2018-2019) was obtained for this study.

Human and Animal Rights

No animal or human experiments were done for this study.

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Consent for being included in this retrospective study without revealing the identity of the patient has been obtained from all study subjects.

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Brindha, H.S., Mohiyuddin, S.M.A., Sagayaraj, A. et al. Outcome of Treatment in Locally Advanced Upper Alveolar Carcinoma Extending to Infra-temporal Fossa. Indian J Otolaryngol Head Neck Surg (2020). https://doi.org/10.1007/s12070-020-01810-3

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Keywords

  • Squamous cell carcinoma
  • Upper alveolus
  • Infra-temporal fossa
  • Resection margins
  • Local recurrence
  • Infra-structure maxillectomy
  • Compartment resection