Pattern of Lymphatic Spread From Carcinoma of the Buccal Mucosa and Its Implication for Less Than Radical Surgery

PurposeWith emerging evidence, focus is shifting to conservative neck procedures aimed at achieving good shoulder function without compromising oncologic safety.Patients and MethodsRetrospective analysis of 100 consecutive neck dissections for carcinoma of the buccal mucosa was carried out to evaluate the pattern of lymphatic spread. Pathologic results were correlated with clinical/radiologic findings. Survival was calculated with the Kaplan-Meier method and log-rank test.ResultsOnly 36 patients were found to harbor metastasis in the lymph nodes on pathologic examination. Most of these were present in levels I and II only. Skip metastasis was not detected in any patient. None of the patients was found to have involvement of level V nodes, whereas 1 patient had involvement of level IV. Thirty-four patients developed recurrences; 3-year disease-free survival was 48%.ConclusionsLymphatic spread from carcinoma of the buccal mucosa is low. Involvement of level IV is seen in only 1% of patients. A more conservative approach to the neck in patients with carcinoma of the buccal mucosa is recommended.