Clinical Profile and Surgical Outcome of Buccal Mucosa Carcinoma in a Rural Tertiary Care Setting: A Retrospective Study

Abstract

Background: Oral squamous cell carcinoma of the buccal mucosa presents significant clinical challenges in rural populations where smokeless tobacco use is endemic. This study aimed to evaluate the clinicopathological profile, surgical outcomes and factors influencing advanced-stage presentation in a rural tertiary care setting in Andhra Pradesh.

Methods: A retrospective observational study was conducted on 45 patients undergoing surgical resection for biopsy-proven primary buccal mucosa carcinoma. Clinical and demographic variables, risk habits, TNM staging at presentation, and surgical outcomes were extracted from institutional records. Statistical associations with clinical stage (Early [I–II] vs. Advanced [III–IV]) were evaluated using Pearson Chi-Square and Fisher’s Exact tests.

Results: The cohort exhibited a distinct female preponderance (62.2%, n=28). Male patients presented with advanced disease at a significantly higher rate than females (76.5% vs. 46.4%, P 0.048). Patients with mixed habits (betelnut products with smoking or alcohol) predominantly presented with advanced disease (75.0%, n=9/12), as did exclusive betel leaf consumers (63.6%, n=7/11), though this association did not reach statistical significance (P 0.356). Advanced stage disease (57.8%) required complex composite resections and major flap reconstructions; the postoperative complication rate was 13.3%, with a mortality rate of 4.4%.

Conclusion: Buccal mucosa carcinoma in this rural cohort is characterized by a high proportion of advanced-stage disease, driven by endemic betelnut product consumption and mixed risk habits. The significant delay in male presentation identifies them as a uniquely vulnerable subgroup, underscoring the need for targeted, community-level screening and tobacco cessation initiatives.