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Gingivobuccal mucosal cancers: resection to reconstruction

More, Yogesh; Sharma, Shilpi; Chaturvedi, Pankaj; D’Cruz, Anil K.

Current Opinion in Otolaryngology & Head & Neck Surgery: April 2014 - Volume 22 - Issue 2 - p 95–100
doi: 10.1097/MOO.0000000000000027
HEAD AND NECK ONCOLOGY: Edited by Piero Nicolai and Cesare Piazza

Purpose of review: Oral cancer is rapidly emerging as a major health problem across the globe. The Southeast Asian subcontinent has a high incidence of oral cancer and gingivobuccal complex forms the commonest subsite. The habit of chewing smokeless tobacco and areca nut are mainly responsible for this site predilection. The majority of literature and guidelines stem from the western world and there is ambiguity about tumor behavior among various continents. Thus, it is imperative to do this review for improving our understanding about this specific subsite, its behavior, treatment and outcomes.

Recent findings: Gingivobuccal mucosal cancers (GBCs) usually present as large lesions with early mandibular involvement and cervical node metastasis. Level I nodes are often the first echelon. Surgical resection of the mandible is often en bloc with primary GBCs. A marginal or segmental mandibular resection is based on paramandibular soft tissue involvement. Microvascular free tissue reconstruction is ideal. Prognostic factors include tumor depth greater than 4 mm, skin involvement, nodal metastases and extra capsular spread.

Summary: Early mandibular involvement and neck node metastases need to be considered in treatment planning. Appropriate reconstruction is key to early recovery and good quality of life.

Department of Head and Neck Surgery, Tata Memorial Hospital, India

Correspondence to Professor Anil K. D’Cruz, Director, Tata Memorial Hospital, E Borges rd, Parel, Mumbai 400012, India. Tel: +91 22 24177000; fax: +91 22 24146937; e-mail: docdcruz@gmail.com

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins