Clinical Outcomes and Patterns of Failure of Post-Operative Buccal Mucosa Cancers Treated with Adjuvant Radiotherapy- A Retrospective Study in A Tertiary Care Hospital

Suvra Mondal, Debajyoti Chowdhury, Ananya Mahalanabish, Sumana Maiti Das, Krishnangshu Bhanja Choudhury
Author(s)
1Senior Resident, MD in Radiation Oncology, Department of Radiation Oncology, Katwa Subdivision Hospital Katwa, Purba Bardhaman, India, 2Senior Resident, MD in Radiation Oncology, Department of Radiation Oncology, Alipurduar District Hospital, Hospital Road, Ward No. 13, Sobhaganj, Alipurduar, India, 3Senior Resident, MD in Radiation Oncology, Department of Radiation Oncology, Sagardighi Multi Super Speciality Hospital, Sagardighi, Murshidabad, India, 4Associate Professor, MBBS, Department of Radiotherapy, R.G. Kar Medical College & Hospital. Khudiram Bose Sarani, Bidhan Sarani, Shyam Bazar,Kolkata, West Bengal, India, 5Associate Professor, MBBS, Department of Radiotherapy, Malda Medical College and Hospital, Malda, West Bengal, India

Abstract

Background: Buccal mucosa carcinoma is the most prevalent oral cavity malignancy in India, which is commonly related to the use of tobacco and alcohol. Standard practice is to use adjuvant radiotherapy to treat advanced-stage disease, which helps control the disease but is not a cure against recurrence. The objective of this study was to determine the demographics, clinical, pathologic, and treatment-related variables that impact the occurrence and disease-free survival (DFS) in patients who are operated on and receive adjuvant radiotherapy for buccal mucosa carcinoma. Material and Methods: A retrospective study of 149 surgically resected patients with carcinoma of the buccal mucosa who underwent adjuvant radiotherapy was conducted. Demographic data, clinical presentation data, tumor staging data, pathological data, recurrence patterns data, metastasis data, and DFS data were gathered and compared. The recurrence was evaluated using appropriate statistical tests to assess associations between patient/tumor characteristics and recurrence. Results: The average age was 57.38 years, with a male-dominated distribution (82.6% prevalence). The majority of the patients were tobacco users (91.9%) and alcohol abusers (54.4%). The most frequently reported presenting complaints were pain (45.6) and ulceration (38.9), with a median duration of 5 months. Those with advanced clinical (cT3–T4a, cN2–N3), pathological, high-grade, positive margins, perineural invasion, depth of invasion above 4 mm, and extracapsular extension were significantly associated with recurrence. The infield recurrence was seen in 36.9% and outfield in 12.1%, and the distant in 20.1%. The average DFS was 24.97 months, with a median of 18 months. Conclusion: The risk factors for the recurrence of buccal mucosa carcinoma include high-risk pathological features, advanced stage, and lifestyle factors. Early diagnosis and extensive surgery, plus close post-operative observation, are necessary to enhance DFS.

Keywords: Buccal mucosa carcinoma, adjuvant radiotherapy, recurrence, disease-free survival, oral cancer.

Outline