Efficacy of adjuvant radiation in early stage cancers of buccal mucosa- an Institutional experience

Purpose: The purpose of this study is to determine if depth of infiltration is the only risk factor that will determine the outcomes in early stage buccal mucosa patients or do the other minor risk factors have an impact too. Methods: It is a retrospective analysis of 226 patients with early stage buccal mucosa cancer who were treated with curative intent from 2010 to 2020. These patients were grouped in two arms, surgery alone(n=111) and surgery followed by adjuvant radiotherapy( n=115). Patients were followed up and local and regional recurrences and distant metastasis were recorded. Results: Our results show that addition of Radiation to the standard surgery arm improves overall survival and disease free survival, though the improvement in overall survival was not statistically significant. This improvement was more pronounced in the depth of infiltration >5mm and in 5mm or less depth of infiltration this benefit was not statistically significant. Other factors like perineural invasion, lymphovascular invasion, tumour size, node positive, margin positive were considered for univariate analysis. Although there was a trend towards improvement of OS and DFS it was not statistically significant as far as these factors are concerned. Conclusion: The role of adjuvant radiation in early stage cancers of buccal mucosa is a crucial tool with definitive DFS benefit and requires more prospective trials to answer the OS benefit.