Results of primary versus salvage surgery in carcinoma of the buccal mucosa.

Of the oral cancer subsites, carcinoma of the buccal mucosa is commonest. Tumor size, tumor stage, nodal status, grade of tumor, performance status, site of primary, thickness, depth of invasion, tumor margin, etc. are reported to be predictors of survival.A total of 142 patients treated with surgery were retrospectively studied. Patients were divided in 2 groups. Group I had 77 patients treated with primary surgery while Group II had 65 patients treated by salvage surgery. Survival analysis was carried out by Kaplan-Meier method and difference between survival was calculated by log rank test. Multivariate analysis was carried out by Cox regression model.The overall disease free survival was 54.3% at 5 years. The survival in males was better than females. However, there was no difference in survival by extent and grade of tumor, margins or type of surgical excision. Presence of lymph nodes, nodal stage of the disease, and perineural invasion was found to significantly reduce survival, while patients with lymphoplasmocytic infiltration had significantly better survival. Gender was the only predictor of survival on multivariate analysis.The results of present study show that there is no difference in survival between patients undergoing primary or salvage surgery. However, these results should be interpreted with caution in absence of randomized controlled trials.