Treatment of Buccal Mucosa Cancer Growing at 2 mm from the Mandibular Alveolar Border Without Bone Invasion
This protocol addresses buccal mucosal squamous cell carcinoma (BMSCC) presenting in a narrow anatomical window — at 2 mm from the mandibular alveolar border — where preoperative radiology shows no bone invasion. The closeness to bone forces a specific surgical decision that is not straightforward.
Clinical Scenario
Buccal mucosal squamous cell carcinoma growing at 2 mm from the mandibular alveolar border, with no bone invasion identified on preoperative radiology. This proximity creates a margin dilemma: whether to extend the resection to achieve clearance at the bone level, or to accept that the soft-tissue margin will be close.
Surgical Approach
The surgical options at this margin distance involve a choice between a procedure that addresses the mandibular border directly versus a more limited resection that accepts the close proximity to bone — each with different implications for margin status.
The full decision framework — including which approach applies and under what conditions — is contained in the complete protocol.
References
DOI: 10.1002/lio2.1081
If a BMSCC grows at 2 mm from the mandibular alveolar border without bone invasion on preoperative radiology 67% would accept an inadequate margin and only remove the periosteum, and 33% would perform a marginal mandibular resection.
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