DOI: http://dx.doi.org/10.18203/2349-2902.isj20185028

A clinicopathological study of cheek carcinoma and different types of reconstructive procedure for its treatment in a tertiary care centre in India

Rupesh Gupta, Chandan Roy Choudhury, Sandipan Gupta

Abstract


Background: The incidence of oral cancer varies globally and regionally and is closely linked with geographical, social, economical, biological, ethnic, dietary and environmental factors. In India, buccal mucosa (cheek) is the most common site for the lesion having 50% of all the oral cavity cancers and the incidence of oral cancers is about 10.6 % of all cancers. The aim of the study was to study the mucosal lesions with regard to mode of presentation, aetiopathology, histopathological aspects, various surgical modalities.

Methods: The prospective observational and descriptive tertiary care institute based case study was undertaken at Medical College, Kolkata. A total of 30 patients were included in the study.

Results: Maximum number of patients was in the 51-60 yr age group and the male: female sex ratio was 7:3. The maximum risk factors were found to be smoking and tobacco. 16.67% patients had premalignant lesions namely leucoplakia whereas 73.33% of the patients presented with oral ulcers as the chief complaint. Most of the patients presented in the late stage. Squamous cell carcinoma was the most common histological type. Out of 30 patients, 6 underwent wide local excision only and the rest underwent neck dissection. Mandibulectomy was done in 14 patients, Pectoralis major myocutaneous flap was the most common reconstructive procedure used (43.33%).

Conclusions: Cancer of the oral cavity accounts for a high incidence in our country due to our social habits. In spite of easy accessibility to early lesion, the number of locally advanced lesion is very high. This can be prevented by creating health awareness.


Keywords


Aetiopathology, Cheek, Carcinoma, Management

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References


Ferlay J, Bray F, Pisani P, Parkin DM GLOBOCAN 2002: Cancer incidence, Mortality and prevalence worldwide, IARC Cancer Base No. 5 version 2.0, IARC Press Lyon; 2004.

Ferlay J, Bray F, Pisani P, Parkin DM. GLOBOCAN 2000: Cancer incidence, Mortality and prevalence worldwide, IARC Cancer Base No. 5 (2001) version 2.0, IARC Press Lyon, 2001.

Kazi R. Surgical management of carcinoma cheek. Head and Neck Cancer. Manipal University, Manipal, India. Med Oral Pathol Oral Radiol Endod. 2005;100:40-51.42.

Jemal A, Thimas A, Murray T, Thun M, Cancer stastistics 2002, CA Cancer J Clin. 2002;42:23-47.

Mayne ST, Morse DE, Winn DM, Schottenfeld D, Fraumeni JF Cancers of the oral cavity and pharynx Cancer epidemiology and prevention 3rd ed. Oxford university Press: New York;2006:674-696.

Boyle P, Mcfarlane GJ, Mcginn R, Zheng T, La Vecchia, Maisonneuve P, et al. International epidemiology of head and neck cancer, In: de Vries N, Gluckman JL (eds), Multiple primary tumours in head and neck, Thieme Medical Publishers, New York;1990:80-138.

Mucci L, Adami H-O, Oral and Pharyngeal Cancer, In: Adami H-O, Hunter D, Trichopoulos D (eds) Textbook of Cancer epidemiology. Oxford University Press: New York;2002:115-128.

Rahaman M, Sakamoto J, Fukui T, Bidi smoking and oral Cancer: a meta analysis. Int J Cancer. 2003;106:600-4.

Scully C, Subdo J, Speight PM. Progress in determining the malignant potential of oral lesions. J Oral Path Med. 2003;32:251-6.

Tilakaratne W, Klinikowski M, Saku T, Peters T, Warnakulasariya. Oral Submucosal fibrosis: Review on aetiology and pathogenesis. Oral Oncology. 2006;42:561-8.

Johnson N, Franceschi S, Ferlay J, Ramadas K, Schmid S, Macdonald DG, et al. Squamous cell carcinoma. In: Barnes L, Eveson JW, Reichart P, Sidransky D (eds) WHO classification of tumours; Pathology and genetics of Head and Neck tumours. IARC press: Lyon. 2005:168-175.

Iyer SG, Pradhan SA, Pai PS, Patil S. Surgical treatment outcomes of localized squamous carcinoma of buccal mucosa. Head Neck. 2004;26:897-902.

Brown JS, Lewis- Jones H. Evidence for imaging the mandible in the management of oral squamous cell carcinoma: a review. Br J Oral Maillofac Surg. 2001;39:411-8.

Bennett RG. Cheek Reconstruction. In: Rohrer, Cook J, Nguyen T, Mellette R, Flaps and Grafts in Dermatologic Surgery, Saunders;2007.

Baker SR. Reconstructive Surgery for Skin Cancer. In: Rigel D, Friedman R, Dzubow L, Reintgen D, Bystryn JC, Marks R, Cancer of Skin, Saunders;2005.

McGurk M, Goodger NM. Head neck cancer and it’s treatment. Br J Oral Maxillofac Surg. 2000;38(3):209-20.

Khafif RA, Gelbfish GA, Asase DK, Tepper P, Attie JN. Modified radical neck dissection in cancer of the mouth pharynx and larynx. Head Neck. 1990;12:476-82.

Samant S, Robbins KT. Evolution of neck dissection for improved functional outcome. World J Srg. 2003;27:805-10.

Buckley JG, Feber T. Surgical treatment of cervical node, metastasis from squamous carcinoma of upper aero digestive tract: Evaluation of the evidence for modifications of neck dissections. Head Neck. 2001;23:907-15.

Pradhan SA, Cruz AK, Gulla RI. What is the optimum neck dissection for T3/4 buccal gingival cancers. Otorhinolaryngology. 1995;252:143-5.

Spiro RH, Morgan GJ, Strong EW, Shah JP. Supraomohyoid neck dissection. Am J Surg. 1996;172:650-3.

Traynor SJ, Cohen JI, Gray J, Andersen PE, Everts EC. Selective neck dissection and the management of the node positive neck. Am J Surg. 1999;172:654-7.

Majaoufre C, Faucher A, Laroche C, De Bonfils C, Siberchicot F, Renaud-Salis JL, et al Supraomohyoid neck dissection in cancer of the oral cavity. Am J Surg. 1999;178:73-7.

Kolli VR, Datta RV, Orner JB, Hicks WL, Loree TR. The role of supraomohyoid neck dissection in patients with positive nodes. Arch Otolaryngol Head Neck Surg. 2000;126:413-6.

Ferlito A, Alessandra R, Silver CE, Gourin CG, Shah JP, Clayman GL et al. Elective and therapeutic neck dissection. Oral Oncol. 2006:42:14-25.

Dhawan IK, Verma K, Khazanchi RK, Madan NC, Shukla NK, Saxena R. Carcinoma of the buccal mucosa :incidence of regional lymph node involvement. Indian J Cancer. 1993;30:176-80.

Nair MK, Sankaranarayan R, Padmanabhan TK, Evaluation of the role of radiotherapy in the managementof carcinoma of buccal mucosa, Cancer. 1988;61:1326-31.

Eicher SA, Overholt SM, El Naggar AK, Byers RM, Weber RS. Lower gingival carcinoma: clinical and pathological determinants of regional metastasis. Arch Otolaryngol Head Neck Surg. 1996;122:634-8.

Woolgar JA. Pathology of the N0 neck. Br J Oral Maxillofacial Sirg. 1999;37:205-9.

Jalisi S. Management of the clinically negative neck in early squamous cell carcinoma of the oral cavity. Otolaryngol Clin North Am. 2005;38:37-46.

Medina JE, Byers RM. Supraomohyoid neck dissection:rationale, indications and surgical technique. Head Neck. 1989;11:111-22.

Henick DH, Silver CE, Heller KS, Shaha AR, Har El G, Walk D. Supraomohyoid neck dissection as a staging procedure for squamous cell carcinoma of the oral cavity and oropharynx. Head Neck. 1995;17:119-23.

Kligerman J, Lima RA, Soares JR, Prado L, Dias FL, Freitas EQ, et al. Supraomohyoid neck dissection in the treatment of T1/T2 squamous cell carcinoma of oral cavity. Am J Surg. 1994:168;391-4.

Kerrejebin JD, Freeman JL, Gullane PJ. Supraomohyoid neck dissection:is it diagnostic or therapeutic? Head Neck. 1999;21:39-41.

Kowalski LP, Magrin J, Waksman G, Santo GF, Lopes ME, de Paula RP, et al. Supraomohyoid neck dissection in the treatment of head and neck tumours. Survival results in 212 cases. Arch Otolaryngol Head Neck Surg. 1993;119:958-63.

Rao RS, Deshmane VH, Parikh DM, Sukthankar PS. Extent of lymph node dissection in T3/T4 cancer of the alveolo-buccal complex. Head Neck. 1995;17:199-203.

Ton Van J, Lefebvere JL, Sarini J. Chemoprevention of head neck cancer. In: Saranath D (ed) Contemporary issues in oral cancer. Oxford University Press: New Delhi;2000:189-212.

Gupta PC, Murti PR, Bhonsle RB. Epidemiology of cancer by tobacco products and the significance of TSNA. Crit Rev Toxicol. 1996;26(2):183-98.

Znoar A, Brennan P, Gajalaksmi V, Mathew A, Shanta V, Varghese C, et al. Independent and combined effects of tobacco smoking, chewing and alcohol drinking on the risk of oral, pharyngeal, oesophageal cancers in Indian men. Int J Cancer. 203;105:681-6.

Scully C. Oral squamous cell carcinoma ;from an hypothesis about a virus, to concern about possible sexual transmission. Oral Oncol. 2002;38(3):227-34.

Murti PR, Bhonsle RB, Pindborg JJ, Daftary Gupta PC, Mehta FS. Malignant transformation rate in oral submucosal fibrosis over a 17 year period. Community Dent Oral Epidemiol. 1985;13:340-1.

Mao L, Hong WK, Papadimitrakopolou VA. Focus on head and neck cancer. Cancer Cell. 2004;5:311-6.

Asif M, Muzafar K. The carcinoma tongue –coincidence of risk factors, presentation and treatment. J Col Physicians Surg Pak. 2000;10:454-7.

Shah JP, Haribaklin V, Loree TR, Sutaria P. Complications of pectoralis major myocutaneous flap in head and neck reconstruction. Am J Surg. 1990;160:352-5.