Prognostic importance of site in squamous cell carcinoma of the buccal mucosa

While stage and grade of oral cancer have a profound and well-recognised influence on outcome, the effect of site is less clear and there have been relatively few published series that specifically address how site affects prognosis. Recent series have found that buccal cancers have a relatively poor prognosis compared with other sites, and suggest that this may be because the tumours are more aggressive. We examined 482 consecutive patients with oral cancers that had been operated on in a single unit, and report the presentation, treatment, and outcome of buccal tumours compared with those of other oral sites with reference to other prognostic variables. There were no significant differences between buccal and other cancers in patients’ characteristics, clinical presentation, or pathological staging, except in buccal tumours that rarely had pT1 stage (n = 13,16%) compared with other sites (n = 112, 28%, pT1-4, p = 0.02). Despite a higher rate of frankly involved margins (p = 0.02), the 5-year disease-specific survival was 70% for buccal tumours compared with 75% for other sites (p = 0.34). We conclude that site had little influence on prognosis, and that the poor outcome of buccal cancers reported from other centres has not been replicated in our series.