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Annals of Surgical Oncology

, 15:2187 | Cite as

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

  • Chun-Ta Liao
  • Shiang-Fu Huang
  • I-How Chen
  • Joseph Tung-Chieh Chang
  • Hung-Ming Wang
  • Shu-Hang Ng
  • Chuen Hsueh
  • Li-Yu Lee
  • Chih-Hung Lin
  • Ann-Joy Cheng
  • Tzu-Chen Yen
Head and Neck Oncology

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.

Keywords

Surgery Tumor control Squamous cell carcinoma Buccal mucosa 

Notes

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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Copyright information

© Society of Surgical Oncology 2008

Authors and Affiliations

  • Chun-Ta Liao
    • 1
    • 2
  • Shiang-Fu Huang
    • 1
    • 2
  • I-How Chen
    • 1
    • 2
  • Joseph Tung-Chieh Chang
    • 2
    • 3
  • Hung-Ming Wang
    • 2
    • 4
  • Shu-Hang Ng
    • 2
    • 5
  • Chuen Hsueh
    • 2
    • 6
  • Li-Yu Lee
    • 2
    • 6
  • Chih-Hung Lin
    • 2
    • 7
  • Ann-Joy Cheng
    • 2
    • 8
  • Tzu-Chen Yen
    • 2
    • 9
  1. 1.Department of Otorhinolaryngology, Head and Neck SurgeryChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
  2. 2.Department of Head and Neck Oncology GroupChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
  3. 3.Department of Radiation OncologyChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
  4. 4.Department of Hema-OncologyChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
  5. 5.Department of Diagnostic RadiologyChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
  6. 6.Department of PathologyChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
  7. 7.Department of Plastic and Reconstructive SurgeryChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
  8. 8.Department of Medical Biotechnology, Biostatistics Consulting Center, Department of Public HealthChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
  9. 9.Department of Nuclear Medicine and Molecular Imaging CenterChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan

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