A New Classification of Buccal Mucosa Squamous Cell Carcinoma and the Corresponding Surgical Strategy

Buccal mucosa squamous cell carcinoma (BSCC) has a poor prognosis. In this study, a new classification system for BSCC and a corresponding surgical strategy are proposed. A total of 210 BSCC patients who underwent continuous tumor en bloc excision and neck lymph node dissection in the Department of Oral and Maxillofacial Surgery at the Second Xiangya Hospital were enrolled. In the new classification, anterior/posterior buccal divisions by the front boundary of the masseter and upper/lower divisions by the occlusion line are defined. The corresponding surgical strategies included through-and-through resection, subzygomatic region resection, anatomical unit resection, and mandibular resection. The 5-year local disease control rate, overall survival rate, and disease-free survival rate of BSCC patients were 87.76, 73.61, and 69.24%, respectively. The local disease control rates in the T1-T2 stage group, I-II clinical stage group, and lymph node-negative group were 94.17, 98.80, and 97.50%, respectively. Our proposed BSCC classification and surgical strategy offer another surgical procedure for treating BSCC.