ABSTRACT
Objectives: Retromolar trigone carcinoma is uncommon but notorious for poor prognosis. We reviewed our experience with primary surgery followed by postoperative radiation therapy or radiochemotherapy to determine the impact of our treatment protocol on the patients' outcome
Patients and Methods: Between May 2001 and April 2005. 23 patients with RMT squamous cell carcinoma were treated in Surgical Oncology Department, Mansoura University Hospitals, Egypt. Surgical excision of the primary tumor and ipsilateral neck dissection was performed in all patients. Reconstruction was accomplished by the pedicled buccal fat pad flap [12 cases] or temporoparietal fascial flap [11 patients]. Patients were followed up for 4-48 months [mean 29 months]. There were 3 patients stage I, 11 stage II, 7 stage III, and 2 stage IV
Results: Posterior marginal mandibulectomy was performed in 11 cases and segmental madibulectomy in 4 cases. Maxillectomy was done in 8 cases. Pathologic reports confirmed mandibular bone invasion in 8 cases [34.7%] and maxillary bone invasion in 7 cases [30.4%]. Metastatic disease was found in 60.9% of ipsilateral neck nodes. Occult metastasis was demonstrated in 38.5% of clinically NO necks. The 3- year locoregional control rate was 73.9% and the overall 3-year survival rate was 69.5%
Conclusion: Squamous cell carcinomas of RMT are aggressive tumors. Posterior marginal mandibulectomy instead of routine mandibular resections and reconstruction by the pedicled buccal fat pad are two steps that made surgical treatment easier without compromise of the oncologic safety