Ultrasound-guided resection of buccal mucosal carcinomas - a multicenter study

Buccal mucosa cancer is a rare disease. In the Netherlands, approximately 100
patients are treated for this disease each year. To obtain good local control,
it is important that the histological distance from the tumor to the resection
plane is 5 mm or more (tumor-free margin). If the tumor-free margin is smaller,
such as close (1-5 mm) or involved (<1 mm) margins, there is usually an
indication for adjuvant therapy. Now, the tumor-free margins in buccal mucosa
cancer are often insufficient, so that a significant proportion of patients
require adjuvant treatment (re-resection or radiotherapy). Postoperative
radiotherapy can greatly reduce the quality of life due to the development of,
for example, osteoradionecrosis, mucositis and fibrosis. During a re-resection
it is often difficult to find the location of the insufficient margin.
Ultrasound-guided resection can be used to visualize the tumor during surgery,
in order to improve the tumor-free margins. Currently, the tumor-free margin is
only estimated palpably and frozen sections are sometimes used in case of
doubt.

The aim of this research is to decrease the number of involved margins,
resulting in less adjuvant therapy and less local recurrences.

In this trial, 70 patients with a squamous cell carcinoma of the buccal mucosa
will be included for treatment with ultrasound-guided resection. This is a
prospective, non randomized trial.

Ultrasound-guided resection of buccal mucosa carcinomas

Ultrasound is a non-invasive form of imaging with no harmful effect. The use of
ultrasound during surgery might lead to more removal of healthy tissue,
however, this may lead to less involved margins and adjuvant therapy. The
anesthesia time will last 5-10 minutes longer. Furthermore, on 4 timepoints
(before the operation and 3x in the year after operation) questionnaires will
be send.