Oncotarget

Research Papers:

Unit resection of buccal squamous cell carcinoma: Description of a new surgical technique

Zhen-Hu Ren, Zhao-Jian Gong and Han-Jiang Wu _

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Oncotarget. 2017; 8:52420-52431. https://doi.org/10.18632/oncotarget.14191

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Abstract

Zhen-Hu Ren1,2, Zhao-Jian Gong1 and Han-Jiang Wu1

1Department of Oral and Maxillofacial surgery, Second Xiangya hospital of Central South University, Changsha, Hunan, 410011, China

2Department of Oral Maxillofacial-Head and Neck Oncology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China

Correspondence to:

Han-Jiang Wu, email: wuhanjiang0198@sina.com

Keywords: buccal squamous cell carcinoma, muscle anatomy, surgical treatment, unit resection, survival

Received: October 15, 2016     Accepted: November 20, 2016     Published: December 25, 2016

ABSTRACT

This study characterized the infiltration of primary tumors along the muscles, fascia and spaces of the maxillofacial region in buccal squamous cell carcinoma (BSCC) and suggested a new surgical strategy that is suitable for most stages. Based on the anatomic characteristics and infiltration of the primary tumor a new surgical approach - unit resection buccal surgery (URBS) - was developed. We evaluated this new surgical strategy, across a cohort of 127 BSCCs: 60 cases treated with URBS and 67 cases treated with conventional surgery. Notably there was no statistical difference in the clinicopathological variables between the two groups. After initial treatment with curative intent, the patients were regularly followed-up with clinical examination and imaging. URBS proved suitable for almost all stages of BSCC, and was particularly advantageous for advanced stages of BSCC. At 2 years post-treatment, the rates of overall survival were 83.3% in the URBS group and 60.1% in the conventional surgery group, respectively (hazard ratio 0.38; 95% CI 0.20 to 0.75; P=0.005). Similarly, the rates of disease-free survival were 76.6% and 51.9% in the URBS group and the conventional surgery group, respectively (hazard ratio 0.42; 95% CI 0.23 to 0.75; P=0.003). The principles of URBS are suitable for almost all stages of BSCC, especially advanced stages. URBS may improve the prognosis of BSCC patients.


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