Muhammad Ayub Musani, Itrat Jawed, Saleem Marfani, Yousuf Khambaty, M. Jalisi, Shahbaz Ali Khan


Background: Oral cancer varies globally and regionally, and is closely linked with geographical,
social, economical, biological, ethnic, dietary and environmental factors. In western countries it
accounts for about 2–5% while in the south-east Asia for about 40% of all cancers. In Pakistan it is
second commonest tumour after bronchogenic carcinoma in males and breast carcinoma in
females. The objectives of this study were to find out the pattern of carcinoma cheek in our region,
its etiological associations, management and prognosis. This study was conducted in the
Otolaryngology and Head and Neck Surgery Department of Civil Hospital, Karachi from April 1995
to December 1998. It was prospective study. Methods: Forty-five cases of primary carcinoma cheek
were diagnosed and investigations including OPG and CT scan were carried out along with other
required investigations to evaluate the extension of tumour, bony erosion and metastasis. TNM
staging was done. All patients were treated surgically, sent for post-operative radiotherapy or
chemoradiation and followed up for 3 years. Result: Among 45 cases of oral cancer, 28 were
females and 17 were males. Common presenting symptom was growth or ulcer. It was more
common in 41–50 years of age. Squamous cell carcinoma (SCC) was found in 95.5% of the cases.
Most of the patients 31 (68%) were in T4 stage. Surgical excision was done in all cases with
reconstructuion in 23 cases and neck dissection in 39 cases. In the follow up for 3 years, 30 patient
remained disease free. Conclusion: Carcinoma cheek is a common entity in our region and now it is
seen in relatively younger patients. Oral cancer is a self preventable disease. What is required is to
develop awareness of oral hygiene and discourage the habit of social carcinogens use. Early
diagnosis and treatment offers better chance of cure whereas advance disease has a poor prognosis.
Keywords: Oral cavity squamous cell carcinoma (OSCC), supraomohyoid neck dissection.

Full Text:



Wang CC, Kelly J, August M, Donoff B, Early carcinoma of

the oral cavity. A conservative approach with radiation

therapy. J Oral Maxillofac Surg 1995;53:687–90.

Lamey PJ, Douglas PS, Napier SS. Secretor status and oral

cancer. Br J Oral maxillofac Surg 1994;32:214–7.

Jafarey NA, Zaidi SHM. Cancer in Pakistan. J Pak Med

Assoc 1987;37:178–83.

Bhurgri Y, Bhurgri A, Parvez S, Bhurgri M, Kayani

N, Ahmed R, et al. Cancer profile of Hyderabad, Pakistan

–2002. Asian Pac J Cancer Prev 2005;6:474–80.

Rehman M, Jaferi J. Carcinoma of oral cavity and oropharynx

in Pakistan. An appraisal. Trop Doct 1976;6:63–7.

Jayant K. Balakrishnan V. Sanghvi LD, Jussawalla DJ.

Quantification of the role of smoking and chewing tobacco in

oral, pharyngeal and oesophageal cancers. Br J Cancer


Shimkage M, Horii K, Tempaku A Kakudo K, Shirasaka

T, Sasagawa T. Association of epstein-Barr virus with oral

cancers. Hum Pathol 2002;33(6):608–14.

Kobayashi I, Kaori S, Saito I, Kiyoshima T, Matsuo K, Ozeki

S, et al. Prevalence of Epstein-Barr virus in oral squamous

cell carcinoma. J Pathol 1999;189(1):34–9.

Miller CS, Johnstone BM. Human paillomavirus as a risk

factor for oral squamous cell carcinoma: a meta-analysis,

–1997. Oral Surg Oral Med Oral Pathol Oral Radiol

Endod 2002;93:622–35.

Kreimer AR, Clifford GM, Snijders PJ Castellsagué

X, Meijer CJ, Pawlita M, et al. HPV16 semiquantitative viral

load and serologic biomarkers in oral and oropharyngeal

squamous cell carcinoma. Int J Cancer 2005;115:329–32.

Guha N, Boffetta P, Wünsch Filho V, Eluf Neto J, Shangina

O, Zaridze D, et al. Oral health and risk of squamous cell

carcinoma of the head and neck and esophagus: results of

two multicentric case-control studies. Am J Epidemiol.


Zaidi SH. A clinical monograph on oral cancer. Karachi:

Royal book company Karachi; 1995. pp. 41,47,133,136,141,

Hameed A. Rehabilitaion of patients with oral carcinoma. PL

Grant Report, department of surgery, Jinnah Postgradute

Medical Centre, Karachi 1979.

Zakai MA, Ali SM, Mansoorul Aziz, Tauqeerul Islam.

Etiology of Oral cancer/Squamous Cell carcinoma in oral

cavity. Ann Abbasi Shaheed Hosp Karachi Med Dent Coll


Qureshi S, Trimizi S, Hussian A, Behman A. Is supraomohyoid neck dissection effective in clinically negative node

in T3 and T4 oral tumor. Pak J otolaryngol 2007;23:71–3.

Chhetri DK, Rawnsley JD, Calcaterra TC. Carcinoma of the

buccal mucosa. Otolaryngol Head Neck Surg. 2000;123:566–71.

Noonan VL, Kabani S. Diagnosis and management of

suspicious lesions of the oral cavity. Otolaryngol Clin North

Am 2005;38:21–35.

J Ayub Med Coll Abbottabad 2009;21(3) 91

Klass CM, Shin DMCurrent status and future perspectives of

chemoprevention in head and neck cancer. Curr Cancer Drug

Targets. 2007;7:623–32.

Parkins DM, Pisani P, Perlay J. Estimate of worldwide

incidence of 18 major cancers in 1985. Int J


Khan M, Salam A, Qaim ud Din. Niswar as a risk factor in

the aetiology of oral cavity cancer. J Pak Dent Assoc


Bhurgri Y, Bhurgri A, Hussainy AS, Usman A, Faridi N,

Malik J, et al. Cancer of the oral cavity and pharynx in

Karachi--identification of potential risk factors. Asian Pac J

Cancer Prev. 2003;4(2):125–30.

Macek MD, Reid BC, Yellowitz JA. Oral cancer

examinations among adults at high risk:findings from the

National Health Interview Survey. J Public Health Dent


Shiu MN, Chen TH. Impact of betel quid, tobacco and

alcohol on three stage disease natural history or leukoplakia

and cancer: implication for prevention of oral cancer. Eur J

Cancer Prev 2004;13:39–45.

Reis LAG, Eisner MP, Kosari CL, Edwards Bk. SEER cancer

statistics review, Bathseda (MD): National cancer institute;


Qureshi S, Tirmizi S, Hussain A. Is supraomohyoid neck

dissection is effective in clinically negative node in T3 and

T4 oral tumors. Pak J Otolaryngol 2007;23:71–3.

Kadar AA, Hashmi A. Squamous cell carcinoma of tongue:

Management of 25 cases at tertiary care referral center. Med

Channel 2004;10(2):38–40.

Conley J, Sadoyama J. Squamous cell carcinoma of buccal

mucosa: a review of 90 cases. Eur Arch Otolaryngol


Clayman GL, Frank DK. Selective neck dissection of

anatomically appropriate levels is as efficacious as modified

radical neck dissection for elective treatment of the clinically

negative neck in patients with squamous cell carcinoma of

upper respiratory and digestive tracts. Arch Otolaryngol

Head Neck Surg 1998;124:348–52.

Ahmed MU, Khawar A, Ahmed J, Ajmal M, Bangash WA,

Akhter MR. Occult metastasis in carcinoma of oral cavity.

JCPSP 2007;17(6):313–5.

Wahid A, Ahmad S, Sajjad M. Pattern of carcinoma of oral

cavity reporting at dental department of Ayub Medical

college. J Ayub Med Coll Abbottabad 2005;17:65–6.

Bhurgri Y, Bhurgri A, Rahim A, Butto K et al. The pattern of

malignancies in Karachi 1995–1996. J Pak Med Assoc


Majoufre C, Faucher A, Larcoche C, de Bonofils C,

Siberchicot F, Renauds-Salis JL, et al. Supraomohyoid neck

dissection in cancer of the oral cavity. Am J Surg


Shah JP, Anderson PE. The impact of patterns of nodal

metastasis on modifications of neck dissection. Ann Surg

Oncol 1994;1(6):521–32

Asif M, Muzafar K. The carcinoma tongue-oncidence of risk

factors, presentation and treatment. J Coll Physicians Surg

Pak 2000;10:454–7.

Kroll SS, Goepfert H, Jones M, Guillamondegui

O, Schusterman M.. Analysis of complications in 168

pectoralis major myocutaneous flap used in head and neck

reconstruction. Ann Plastic Surg 1990;25:93–7.

Shah JP. Haribaklin V, Loree TR, Sutaria P. Complications

of pectoralis major myocutaneous flap in head and neck

reconstruction. Am J Surg 1990;160:352–5.

American Cancer Society. Cancer facts and figures 2005.

Atlanta (GA): American Cancer Society 2005.p. 4. available at:

Medina JE, Byers RM. Supraomohyoid neck dissection:

rationale, indications and surgical technique. Head Neck



  • There are currently no refbacks.

Contact Number: +92-992-382571

email: [jamc] [@] []