Traditionally, patients with T4b oral cavity cancer have been deemed inoperable, leading to palliative treatments, primarily radiation and chemotherapy. In this study, we aim to critically evaluate the outcome of surgical intervention, specifically Infra-temporal fossa (ITF) clearance, about disease-free survival and overall survival rates. This is a retrospective observational study conducted over 2 years. 45 patients with clinical-radiological diagnosis of T4b disease, who had been subjected to surgery with ITF clearance were followed up for 2 years to check for recurrence and mortality. Locoregional recurrence was observed in 20 patients (44.4%) among which 3 patients additionally had distant metastasis. At the last follow-up, the overall mortality noted was 26.7%, with 33 patients still alive, out of which 25 were disease-free. No significant correlation was found between patient or tumor-related factors and recurrence rates except positive soft tissue and close bone margins. Survival analysis revealed a mean disease-free survival (DFS) of 18.57 months and an overall survival (OS) of 21.75 months. Surgical resection is a viable option for a few selected patients with locally advanced oral cavity cancer, with acceptable outcomes.
Keywords: Infra Temporal Fossa (ITF); Locally advanced oral cavity Squamous cell carcinoma; Pectoralis Major Myocutaneous (PMMC) flap.
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