Compartmental surgery for squamous cell carcinoma of the buccal mucosa: description of a new surgical technique
Abstract Background Oral squamous cell carcinoma (OSCC) is the sixth most common cancer globally. Patient survival varies depending on tumour stage and oral cavity subsites. Buccal mucosa neoplasia is rare and burdened by worse prognosis than other oral subsites, showing a high rate of loco-regional...
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| Format: | Article |
| Language: | English |
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BMC
2025-03-01
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| Series: | World Journal of Surgical Oncology |
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| Online Access: | https://doi.org/10.1186/s12957-025-03656-x |
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| author | Rita De Berardinis Marta Tagliabue Francesco Chu Fausto Maffini Daniela Lepanto Nicola Fusco Roberto Bruschini Gioacchino Giugliano Stefano Riccio Mohssen Ansarin |
| author_facet | Rita De Berardinis Marta Tagliabue Francesco Chu Fausto Maffini Daniela Lepanto Nicola Fusco Roberto Bruschini Gioacchino Giugliano Stefano Riccio Mohssen Ansarin |
| author_sort | Rita De Berardinis |
| collection | DOAJ |
| description | Abstract Background Oral squamous cell carcinoma (OSCC) is the sixth most common cancer globally. Patient survival varies depending on tumour stage and oral cavity subsites. Buccal mucosa neoplasia is rare and burdened by worse prognosis than other oral subsites, showing a high rate of loco-regional relapses within six months after treatment. According to NCCN guidelines, the gold standard treatment is radical surgery. In the oral cavity, the buccal mucosa subsite lacks anatomical barriers opposing neoplastic growth. At this level, the tumour cells could hypothetically spread along the fibres of the platysma muscle or the lymphatic networks of the peri-facial vessels without encountering any resistance. Due to the aggressive locoregional spread, radical surgery is mandatory to improve patient survival. Methods This technical note describes the cheek compartmental surgical approach step by step. For intermediate-advanced stage cancer, the surgery should include the resection of the tumour with adequate free margins, the dissection of neck lymph nodes and the lymphatic network with the structures between the tumour (T) and the neck (N), the so-called “T-N tract”. The buccal mucosa compartment may be defined as a three-dimensional space between the oral cavity mucosa, the vessel plane, and the lymph nodes of the neck (levels I-IV). These structures, connected by the platysma muscle and the facial vessels, may be considered the T-N tract of the mucosal cheek compartment. Results By removing all the possible pathways of tumour spread via compartmental surgery (en-bloc resection of the tumour with T-N tract and lymphatic network and lymph nodes) for buccal mucosa cancers, one could provide better locoregional control of disease in intermediate-advanced stages. Conclusion This surgical technique may enable a more accurate control of the surgical margins, especially the deep margins. |
| format | Article |
| id | doaj-art-05db2751c8134d71ac87d23e77cb475d |
| institution | DOAJ |
| issn | 1477-7819 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj-art-05db2751c8134d71ac87d23e77cb475d2025-08-20T03:02:19ZengBMCWorld Journal of Surgical Oncology1477-78192025-03-0123111110.1186/s12957-025-03656-xCompartmental surgery for squamous cell carcinoma of the buccal mucosa: description of a new surgical techniqueRita De Berardinis0Marta Tagliabue1Francesco Chu2Fausto Maffini3Daniela Lepanto4Nicola Fusco5Roberto Bruschini6Gioacchino Giugliano7Stefano Riccio8Mohssen Ansarin9Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCSDivision of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCSDivision of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCSDivision of Pathology, IEO, European Institute of Oncology IRCCSDivision of Pathology, IEO, European Institute of Oncology IRCCSDivision of Pathology, IEO, European Institute of Oncology IRCCSDivision of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCSDivision of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCSDivision of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCSDivision of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCSAbstract Background Oral squamous cell carcinoma (OSCC) is the sixth most common cancer globally. Patient survival varies depending on tumour stage and oral cavity subsites. Buccal mucosa neoplasia is rare and burdened by worse prognosis than other oral subsites, showing a high rate of loco-regional relapses within six months after treatment. According to NCCN guidelines, the gold standard treatment is radical surgery. In the oral cavity, the buccal mucosa subsite lacks anatomical barriers opposing neoplastic growth. At this level, the tumour cells could hypothetically spread along the fibres of the platysma muscle or the lymphatic networks of the peri-facial vessels without encountering any resistance. Due to the aggressive locoregional spread, radical surgery is mandatory to improve patient survival. Methods This technical note describes the cheek compartmental surgical approach step by step. For intermediate-advanced stage cancer, the surgery should include the resection of the tumour with adequate free margins, the dissection of neck lymph nodes and the lymphatic network with the structures between the tumour (T) and the neck (N), the so-called “T-N tract”. The buccal mucosa compartment may be defined as a three-dimensional space between the oral cavity mucosa, the vessel plane, and the lymph nodes of the neck (levels I-IV). These structures, connected by the platysma muscle and the facial vessels, may be considered the T-N tract of the mucosal cheek compartment. Results By removing all the possible pathways of tumour spread via compartmental surgery (en-bloc resection of the tumour with T-N tract and lymphatic network and lymph nodes) for buccal mucosa cancers, one could provide better locoregional control of disease in intermediate-advanced stages. Conclusion This surgical technique may enable a more accurate control of the surgical margins, especially the deep margins.https://doi.org/10.1186/s12957-025-03656-xBuccal mucosa squamous cell carcinomaBuccal mucosaMucosal cheekCompartmental surgeryOral squamous cell carcinoma |
| spellingShingle | Rita De Berardinis Marta Tagliabue Francesco Chu Fausto Maffini Daniela Lepanto Nicola Fusco Roberto Bruschini Gioacchino Giugliano Stefano Riccio Mohssen Ansarin Compartmental surgery for squamous cell carcinoma of the buccal mucosa: description of a new surgical technique World Journal of Surgical Oncology Buccal mucosa squamous cell carcinoma Buccal mucosa Mucosal cheek Compartmental surgery Oral squamous cell carcinoma |
| title | Compartmental surgery for squamous cell carcinoma of the buccal mucosa: description of a new surgical technique |
| title_full | Compartmental surgery for squamous cell carcinoma of the buccal mucosa: description of a new surgical technique |
| title_fullStr | Compartmental surgery for squamous cell carcinoma of the buccal mucosa: description of a new surgical technique |
| title_full_unstemmed | Compartmental surgery for squamous cell carcinoma of the buccal mucosa: description of a new surgical technique |
| title_short | Compartmental surgery for squamous cell carcinoma of the buccal mucosa: description of a new surgical technique |
| title_sort | compartmental surgery for squamous cell carcinoma of the buccal mucosa description of a new surgical technique |
| topic | Buccal mucosa squamous cell carcinoma Buccal mucosa Mucosal cheek Compartmental surgery Oral squamous cell carcinoma |
| url | https://doi.org/10.1186/s12957-025-03656-x |
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