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Aim <p>Buccal mucosal squamous cell carcinoma (BSCC) is a locally aggressive malignancy with a high rate of locoregional spread, particularly to deep anatomical spaces. Conventional resections often fail to achieve adequate oncologic margins in these regions. This systematic review aimed to evaluate the effectiveness of compartmental surgery in the management of advanced T4b BSCC involving masticator space by assessing oncological outcomes, recurrence rates, and survival.</p> Methodology <p>A systematic review was conducted following PRISMA guidelines. Electronic searches were performed across PubMed, Web of Science, and Google Scholar for studies published between 2010 and 2025. Studies were included if they reported outcomes following compartment resection for T4b BSCC with masticatory space involvement. Two independent reviewers (Reviewer A and Reviewer B) screened titles, abstracts, and full texts for eligibility, and discrepancies were resolved through discussion. Outcome measures included overall survival (OS), disease-free survival (DFS), local recurrence, distant metastasis, margin status, and nodal involvement. The quality of evidence was appraised using the Oxford Centre for Evidence-Based Medicine (OCEBM) criteria, and the Cochrane Risk of Bias tool was used to assess study quality.</p> Results <p>Of 116 records identified, four observational studies met the inclusion criteria, comprising 181 patients with T4b BSCC. Across the included studies, OS ranged from 51.9% to 84.4% and DFS from 59.6% to 84.4% at a median follow-up of 21–29 months. Positive margin rates varied from 6.7% to 40.4%, while local recurrence rates ranged from 4.4% to 40.7%, with higher recurrence associated with positive margins and nodal disease. All studies were judged to have a moderate overall risk of bias.</p> Conclusion <p>Compartmental resection appears technically feasible in selected patients with advanced BSCC involving the masticator space. Available evidence suggests potential for acceptable margin control and short-term survival outcomes, although comparative data are lacking.</p>

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Compartmental Surgery for Advanced Buccal Mucosal Squamous Cell Carcinoma Involving the Masticator Space: A Systematic Review of Current Oncologic Evidence and Feasibility

  • 期刊论文

  • 发表日期：

    2026年4月2日

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  • Tanya Takkar,
  • S. Gidean Arularasan,
  • Murugesan Krishnan,
  • M. P. Santhosh Kumar

摘要

Aim

Buccal mucosal squamous cell carcinoma (BSCC) is a locally aggressive malignancy with a high rate of locoregional spread, particularly to deep anatomical spaces. Conventional resections often fail to achieve adequate oncologic margins in these regions. This systematic review aimed to evaluate the effectiveness of compartmental surgery in the management of advanced T4b BSCC involving masticator space by assessing oncological outcomes, recurrence rates, and survival.

Methodology

A systematic review was conducted following PRISMA guidelines. Electronic searches were performed across PubMed, Web of Science, and Google Scholar for studies published between 2010 and 2025. Studies were included if they reported outcomes following compartment resection for T4b BSCC with masticatory space involvement. Two independent reviewers (Reviewer A and Reviewer B) screened titles, abstracts, and full texts for eligibility, and discrepancies were resolved through discussion. Outcome measures included overall survival (OS), disease-free survival (DFS), local recurrence, distant metastasis, margin status, and nodal involvement. The quality of evidence was appraised using the Oxford Centre for Evidence-Based Medicine (OCEBM) criteria, and the Cochrane Risk of Bias tool was used to assess study quality.

Results

Of 116 records identified, four observational studies met the inclusion criteria, comprising 181 patients with T4b BSCC. Across the included studies, OS ranged from 51.9% to 84.4% and DFS from 59.6% to 84.4% at a median follow-up of 21–29 months. Positive margin rates varied from 6.7% to 40.4%, while local recurrence rates ranged from 4.4% to 40.7%, with higher recurrence associated with positive margins and nodal disease. All studies were judged to have a moderate overall risk of bias.

Conclusion

Compartmental resection appears technically feasible in selected patients with advanced BSCC involving the masticator space. Available evidence suggests potential for acceptable margin control and short-term survival outcomes, although comparative data are lacking.