Annals of Surgical Oncology

, Volume 5, Issue 6, pp 502–510 | Cite as

Surgery versus surgery and postoperative radiotherapy in squamous cell carcinoma of the buccal mucosa: A comparative study

  • Sanjay Dixit
  • Rakesh K. Vyas
  • Rajendra B. Toparani
  • Harshad A. Baboo
  • Devendre D. Patel
Original Articles


Background: The efficacy of postoperative radiotherapy for squamous cell carcinoma of the buccal mucosa was evaluated.

Methods: One hundred seventy-six patients treated between 1989 and 1993 were analyzed. One hundred fifteen patients were treated with surgery alone (Group 1), and 61 patients were treated with a combination of surgery and postoperative radiotherapy (Group 2).

Results: Actuarial 3-year locoregional control in Groups 1 and 2 was 11% and 48% for patients with stage III + IV cancer (P=.001) and 71% and 75% for patients with stage I + II cancer (P=.74), respectively. On multivariate analysis for locoregional failure, surgical margin, bone invasion, high grade, and node involvement were significant factors in Group 1, whereas in Group 2 only tumor thickness was a significant factor. For local failure, margin, bone invasion, and stage in Group 1 and tumor thickness in Group 2 appeared as significant factors. For nodal failure, clinical nodal (cl N0 vs. N+) stage and grade in Group 1 and pathologic nodal stage (pN0 + 1 vs. pN2) in Group 2 were observed as significant factors. On subset analysis, postoperative radiotherapy was observed to have a significant advantage for surgical margins of 2 mm or less in both early pT (T1 + T2) (P=.019) and late pT (T3 + T4) (P=.016) stages. The local failure rate was higher if the time between surgery and radiotherapy was greater than 30 days.

Conclusions: Postoperative radiotherapy was effective in decreasing locoregional failure in patients with close surgical margins, tumor thicker than 10 mm, high-grade tumors, positive node, and bone invasion. The effect of interval between surgery and postoperative radiotherapy on local failure was margin-dependent.

Key Words

Head and neck surgery Tumor thickness Postoperative radiotherapy Prognostic factors Cheek 


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Copyright information

© The Society of Surgical Oncology, Inc. 1998

Authors and Affiliations

  • Sanjay Dixit
    • 1
  • Rakesh K. Vyas
    • 1
  • Rajendra B. Toparani
    • 2
  • Harshad A. Baboo
    • 1
  • Devendre D. Patel
    • 2
  1. 1.From the Department of Radiation OncologyThe Gujarat Cancer and Research InstituteAhmedabadIndia
  2. 2.the Department of Surgical OncologyThe Gujarat Cancer and Research InstituteAhmedabadIndia

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