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When Does Skin Excision Allow the Achievement of an Adequate Local Control Rate in Patients with Squamous Cell Carcinoma Involving the Buccal Mucosa?

  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The role of cheek skin excision in patients with squamous cell carcinoma of the buccal mucosa (BSCC) remains controversial. We sought to investigate when skin excision is needed to achieve an adequate local control.

Methods

A total of 331 patients with BSCC were reviewed. Skin preservation was pursued when the distance between the tumor and the skin as determined by imaging was ≥13 mm (1 cm surgical margin plus 0.3 cm skin preservation). Two hundred and thirty patients (69.5%) underwent skin excision. Postoperative adjuvant radiotherapy (n = 182) was performed in patients with pathological T4 disease, metastases in cervical lymph nodes or close pathological margins (≤4 mm). The 5-year local control rate was plotted by Kaplan–Meier analysis.

Results

Twenty-four patients (7.3%) had close pathological margins. The 5-year local control rate did not differ significantly between patients treated either with or without skin excision. This was verified both in subjects who received surgery alone (94% versus 91%) and in those who received surgery plus adjuvant therapy (82% versus 86%).

Conclusion

In patients with BSCC, a good 5-year local control rate may be equally achieved either with or without skin excision. In patients with pT3 disease, postoperative radiotherapy is not recommended in the absence of close pathological margins. Our findings may guide clinical decision-making on skin excision in this patient group.

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Acknowledgements

This research was supported by grant NMRPG 160031 from the Chang Gung Memorial Hospital.

Conflicts of Interest Statement The authors indicated no potential conflicts of interest.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Chun-Ta Liao MD, Shiang-Fu Huang MD & I-How Chen MD

  2. Department of Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Chun-Ta Liao MD, Shiang-Fu Huang MD, I-How Chen MD, Joseph Tung-Chieh Chang MD, MHA, Hung-Ming Wang MD, Shu-Hang Ng MD, Chuen Hsueh MD, Li-Yu Lee MD, Chih-Hung Lin MD, Ann-Joy Cheng PhD & Tzu-Chen Yen MD, PhD

  3. Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Joseph Tung-Chieh Chang MD, MHA

  4. Department of Hema-Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Hung-Ming Wang MD

  5. Department of Diagnostic Radiology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Shu-Hang Ng MD

  6. Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Chuen Hsueh MD & Li-Yu Lee MD

  7. Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Chih-Hung Lin MD

  8. Department of Medical Biotechnology, Biostatistics Consulting Center, Department of Public Health, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Ann-Joy Cheng PhD

  9. Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Tzu-Chen Yen MD, PhD

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  1. Chun-Ta Liao MD
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  2. Shiang-Fu Huang MD
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  3. I-How Chen MD
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  4. Joseph Tung-Chieh Chang MD, MHA
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  8. Li-Yu Lee MD
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  11. Tzu-Chen Yen MD, PhD
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Correspondence to Tzu-Chen Yen MD, PhD.

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Liao, CT., Huang, SF., Chen, IH. et al. When Does Skin Excision Allow the Achievement of an Adequate Local Control Rate in Patients with Squamous Cell Carcinoma Involving the Buccal Mucosa?. Ann Surg Oncol 15, 2187–2194 (2008). https://doi.org/10.1245/s10434-008-9980-4

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  • DOI: https://doi.org/10.1245/s10434-008-9980-4

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