In-Continuity Neck Dissection: Long-Term Oncological Outcomes in Squamous Cell Carcinoma of the Buccal Mucosa

Abstract

Purpose: To introduce in-continuity neck dissection (ND) in squamous cell carcinoma of the buccal mucosa (BMSCC) and to determine its impact on the oncologic outcomes of these patients.

Materials and methods: A retrospective review of patients treated for BMSCC from 2006 through 2016 was performed. Kaplan-Meier analysis and log-rank test were used to evaluate local control, regional control (RC), distant metastasis (DM), and disease-specific survival (DSS) of in-continuity ND versus discontinuous ND in 220 previously untreated patients with BMSCC, followed by a multivariate Cox regression that included all relevant variables.

Results: Fifty-three patients received discontinuous ND and 167 patients received in-continuity ND. The 2 groups were comparable. Univariate Kaplan-Meier analysis showed that 5-year DSS rates for the discontinuous ND and in-continuity ND groups were 38 and 62% (P = .023), respectively. The 5-year RC rate for the in-continuity ND group (81%) was significantly better (P = .004) than for the discontinuous ND group (54%). At Cox regression analysis, in-continuity ND meaningfully contributed to a higher RC rate and subsequently better DSS.

Conclusion: Compared with discontinuous ND, in-continuity ND predicted favorable oncologic outcomes in patients with BMSCC. In-continuity ND could be a practical approach in the surgical management of BMSCC.