{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T11:23:33Z","timestamp":1783164213804,"version":"3.54.6"},"reference-count":19,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head & Neck"],"published-print":{"date-parts":[[2026,8]]},"abstract":"ABSTRACT<\/jats:title>\n \n Introduction<\/jats:title>\n Buccal mucosa cancers are the most prevalent oral cavity cancers in South Asia, often attributed to widespread tobacco use. The current NCCN guidelines generally advise against primary surgery for locally very advanced (cT4b) buccal cancers involving the masticatory space and infratemporal fossa (ITF). However, some surgeons have adopted an aggressive surgical approach for T4b oral squamous cell carcinoma, involving composite resections and ITF clearance.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n This is a retrospective analytical survival study of 91 patients with very locally advanced buccal mucosa cancers with involvement of ITF (cT4b), who underwent radical surgery in the form of bi\u2010alveolar composite resection with ITF clearance and Modified Neck Dissection from 2017 to 2023.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n At a median follow\u2010up of 27\u2009months, 54.9% of patients were alive and disease\u2010free. The estimated mean 3\u2010year overall survival (OS) and disease\u2010free survival were 48% and 44%, respectively. In multivariate survival analysis, maxillary sinus involvement (\n p<\/jats:italic>\n \u2009=\u20090.008), no response to neoadjuvant chemotherapy (\n p<\/jats:italic>\n \u2009=\u20090.004), and nodal involvement (\n p<\/jats:italic>\n \u2009=\u20090.05) were independent predictors of poor OS. Patients with high ITF involvement (\n n<\/jats:italic>\n \u2009=\u200923) had a higher rate of distant metastasis compared to those with low ITF involvement (\n n<\/jats:italic>\n \u2009=\u200968;\n p<\/jats:italic>\n \u2009<\u20090.015). Presence of extra\u2010nodal extension also significantly reduced survival across both groups (median OS: 10\u2009months vs. 6.8\u2009months;\n p<\/jats:italic>\n \u2009=\u20090.037).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n ITF clearance is a safe and effective approach for managing locally very advanced (cT4b) buccal cancers.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/hed.70220","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T01:58:33Z","timestamp":1773194313000},"page":"2135-2143","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Infratemporal Fossa Clearance on Survival in Advanced Buccal Mucosa Cancers"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4977-3779","authenticated-orcid":false,"given":"Sudhir","family":"Nair","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgical Oncology Tata Memorial Centre (ACTREC), HBNI Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rathan","family":"Shetty","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgical Oncology Tata Memorial Centre (ACTREC), HBNI Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Bhawalkar","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgical Oncology Tata Memorial Centre (ACTREC), HBNI Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6114-5930","authenticated-orcid":false,"given":"Poonam","family":"Joshi","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgical Oncology Tata Memorial Centre (ACTREC), HBNI Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8119-8439","authenticated-orcid":false,"given":"Arjun","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgical Oncology Tata Memorial Centre (ACTREC), HBNI Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitesh","family":"Singhavi","sequence":"additional","affiliation":[{"name":"Department of Oncosciences Krishna Institute of Medical Science (KIMS) Thane India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jitendra Kumar","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgical Oncology Tata Memorial Centre (ACTREC), HBNI Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shwetabh","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Tata Memorial Centre (ACTREC), HBNI Mumbai 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Surgical Oncology Tata Memorial Centre (ACTREC), HBNI Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1735598"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijc.IJC_445_17"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20195"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11864-017-0484-y"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.4103\/crst.crst_293_21"},{"key":"e_1_2_11_8_1","volume-title":"NCCN Guidelines \u2010 Head and Neck Cancers","author":"National Comprehensive Cancer 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