{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:28:35Z","timestamp":1790882915489,"version":"4.1.0"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T00:00:00Z","timestamp":1697068800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>This study aimed to determine the patterns of invasion of oral squamous cell carcinoma (OSCC) into the bucco-mandibular space (BMS) using detailed histopathological analysis and to assess clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with OSCC who underwent segmental mandibulectomy or hemi-mandibulectomy combined with resection of the BMS between 2012 and 2021 were included. The invasions of the BMS were classified into three patterns. Pattern A was defined as a horizontal invasion, Pattern B as a vertical invasion, and Pattern C as an expansive invasion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 109 patients were reviewed. Of these 109 patients, the primary tumor affected the lower gingiva in 78 patients, the buccal mucosa in 18 patients, and was a primary intraosseous carcinoma of the mandible in 13 patients. Invasion of the BMS was significantly associated with a higher pathological T stage, positive\/close margins, and lower disease-free survival (DFS) rates. The DFS rates were 86.7% and 66.0% in the BMS non-invasion and invasion groups, respectively. The DFS rates for each type of invasion were 82.1% for Pattern A, 67.4% for Pattern B, and 48.0% for Pattern C (P=0.277).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with BMS invasion have a poorer prognosis than those without invasion of the BMS. Therefore, adjuvant therapy is necessary, especially in Patterns B and C. Evaluation of preoperative BMS invasion patterns is important for predicting the prognosis of OSCC.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2023.1168376","type":"journal-article","created":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T16:49:18Z","timestamp":1697129358000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Invasion of the bucco-mandibular space by oral squamous cell carcinoma: histopathological analysis of invasion pattern"],"prefix":"10.3389","volume":"13","author":[{"given":"Takuma","family":"Kugimoto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoto","family":"Nishii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Oikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Kuroshima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideaki","family":"Hirai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirofumi","family":"Tomioka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuyuki","family":"Michi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kou","family":"Kayamori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junichiro","family":"Sakamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe","family":"Iwanaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Shane","family":"Tubbs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tohru","family":"Ikeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Miura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Harada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,10,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.22964","article-title":"A new space of the face: The bucco-mandibular space","volume":"30","author":"Iwanaga","year":"2017","journal-title":"Clin Anat"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2018.09.022","article-title":"Invasion of the mandible in gingivobuccal complex cancers: Histopathological analysis of routes of tumor entry and correlation with preoperative assessment","volume":"86","author":"Chaukar","year":"2018","journal-title":"Oral Oncol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26360","article-title":"Oral squamous cell carcinoma: Aggressive tumor pattern of invasion predicts direct mandible invasion","volume":"42","author":"Yue","year":"2020","journal-title":"Head Neck"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2020.104708","article-title":"Comparison of 50- and 66-Gy total irradiation dose for postoperative cervical treatment of patients with oral squamous cell carcinoma","volume":"107","author":"Hirai","year":"2020","journal-title":"Oral Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19830615)51:12<2175::aid-cncr2820511205>3.0.co;2-m","article-title":"Mode of invasion, bleomycin sensitivity, and clinical course in squamous cell carcinoma of the oral cavity","volume":"51","author":"Yamamoto","year":"1983","journal-title":"Cancer"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.otoeng.2020.04.007","article-title":"Impact of skin invasion on long-term survival outcomes in gingivobuccal complex carcinoma","volume":"72","author":"Panda","year":"2021","journal-title":"Acta Otorrinolaringol Esp (Engl Ed) Endl"},{"key":"B7","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1002\/hed.20195","article-title":"Advanced squamous cell carcinoma of lower gingivobuccal complex: Patterns of spread and failure","volume":"27","author":"Pathak","year":"2005","journal-title":"Head Neck"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2008.08.010","article-title":"Determination of deep surgical margin based on anatomical architecture for local control of squamous cell carcinoma of the buccal mucosa","volume":"45","author":"Ota","year":"2009","journal-title":"Oral Oncol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1308\/003588408X301136","article-title":"Management of gingivobuccal complex cancer","volume":"90","author":"Misra","year":"2008","journal-title":"Ann R Coll Surg Engl"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2019.02.001","article-title":"Survival outcomes after treatment of cancer of the oral cavity (1985\u20132015)","volume":"90","author":"Zanoni","year":"2019","journal-title":"Oral Oncol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2013.12.009","article-title":"Preoperative evaluation of oral tongue squamous cell carcinoma with intraoral ultrasound and magnetic resonance imaging- comparison with histopathological tumour thickness and accuracy in guiding patient management","volume":"43","author":"Yesuratnam","year":"2014","journal-title":"Int J Oral Maxillofac Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"20992","DOI":"10.1038\/s41598-021-00398-0","article-title":"MRI before biopsy correlates with depth of invasion corrected for shrinkage rate of the histopathological specimen in tongue carcinoma","volume":"11","author":"Harada","year":"2021","journal-title":"Sci Rep"},{"key":"B13","article-title":"A potential pitfall of MR imaging for assessing mandibular invasion of squamous cell carcinoma in the oral cavity","volume":"27","author":"Imaizumi","year":"2006","journal-title":"AJNR Am J Neuroradiol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/s0266-4356(02)00116-x","article-title":"Factors that influence the method of mandibular resection in the management of oral squamous cell carcinoma","volume":"40","author":"Brown","year":"2002","journal-title":"Br J Oral Maxillofac Surg"},{"key":"B15","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.oraloncology.2018.01.013","article-title":"Do we need a different staging system for tongue and gingivobuccal complex squamous cell cancers","volume":"78","author":"Gupta","year":"2018","journal-title":"Oral Oncol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2013.08.001","article-title":"Retromolar trigone squamous cell cancers: A reappraisal of 16 section MDCT for assessing mandibular invasion","volume":"68","author":"Arya","year":"2013","journal-title":"Clin Radiol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.4103\/0019-509X.178410","article-title":"Pathology of advanced buccal mucosa cancer involving masticator space (T4b)","volume":"52","author":"Trivedi","year":"2015","journal-title":"Indian J Cancer"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1259\/dmfr.20140111","article-title":"Pathways involved in the spread of buccal carcinoma on contrast-enhanced multislice CT","volume":"44","author":"Xu","year":"2015","journal-title":"Dento Maxillo Fac Radiol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-009-1201-7","article-title":"Prognostic factors for loco-regional failure in early stage (I and II) squamous cell carcinoma of the gingivobuccal complex","volume":"267","author":"Walvekar","year":"2010","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.5125\/jkaoms.2016.42.3.133","article-title":"Muscular invasion by oral squamous cell carcinoma of the posterior mandibular alveolar ridge is associated with cervical lymph node metastasis","volume":"42","author":"Min","year":"2016","journal-title":"J Korean Assoc Oral Maxillofac Surg"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2008.04.007","article-title":"Squamous cell carcinoma of the gingivobuccal complex: Predictors of locoregional failure in stage III-IV cancers","volume":"45","author":"Walvekar","year":"2009","journal-title":"Oral Oncol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3181d95c37","article-title":"Validation of the histologic risk model in a new cohort of patients with head and neck squamous cell carcinoma","volume":"34","author":"Brandwein-Gensler","year":"2010","journal-title":"Am J Surg Pathol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajoms.2021.11.004","article-title":"Immunohistochemical investigation of biomarkers for predicting adipose tissue invasion in oral squamous cell carcinoma","volume":"34","author":"Han","year":"2022","journal-title":"J Oral Maxillofac Surg Med Pathol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2023.1168376\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T16:49:20Z","timestamp":1697129360000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2023.1168376\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,12]]},"references-count":23,"alternative-id":["10.3389\/fonc.2023.1168376"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2023.1168376","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,12]]},"article-number":"1168376"}}