Literature DB >> 14648856

Rim versus sagittal mandibulectomy for the treatment of squamous cell carcinoma: two types of mandibular preservation.

Mario Fernando Muñoz Guerra1, Francisco J Rodríguez Campo, Luis Naval Gías, Jesús Sastre Pérez.   

Abstract

BACKGROUND: The role of conservative mandibulectomy for patients with bone invasion from squamous cell carcinoma remains poorly defined. However, marginal mandibular resection is biomechanically secure in its design while maintaining the mandibular continuity. This procedure has proven to be a successful method of treating squamous cell carcinoma with limited mandibular involvement.
PURPOSE: The purpose of this study was to analyze our results after the use of a marginal technique for the treatment of oral and oropharyngeal cancer and to compare two types of mandibular conservative procedures: rim resection versus sagittal inner mandibulectomy.
METHODS: A retrospective review of a cohort of 50 patients (global group) who underwent mandibular conservative resection for previously untreated squamous cell carcinoma was performed. Two subgroups were considered: rim group (n = 37) and sagittal group (n = 13). Clinical evaluation and preoperative radiologic studies were the means used to evaluate bony invasion and to decide on the extent of mandibulectomy. The treatment outcome after these two types of mandibular resection was calculated and compared using analysis by the Pearson chi(2) test, logistic regression model for multivariate analysis, and the Kaplan-Meier method to determine survival. RESULTS.: In the sagittal group, specimens from 2 patients (11.7%) demonstrated tumor invasion on decalcified histologic examination, whereas the rim group showed 11 cases (29.7%) with bone invasion. Local recurrence was observed in the follow-up of 10 patients. No statistical relationship was found between the presence of histologic bone invasion and the risk of local recurrence. The size of bone resection >4 cm (p =.002) and tumor invasion of surgical margins (p =.039) were found to be associated with increased local recurrence rates. In multivariate analysis, lymph node affectation significantly correlated with histologic mandibular involvement (p =.02). In the global group, the 5-year observed survival rate was 56.97%. Overall survival and rate of recurrence were comparable in both groups. In the global group, tumor infiltration beyond the surgical margin was statistically related with poor survival (p =.01).
CONCLUSIONS: Analysis of this series disclosed that marginal mandibulectomy is effective in the control of squamous cell carcinomas that are close to or involving the mandible. In carefully selected patients, sagittal bone resection seems to be as appropriate as rim resection in the local control of these tumors. Copyright 2003 Wiley Periodicals, Inc. Head and Neck 25: 000-000, 2003

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Year:  2003        PMID: 14648856     DOI: 10.1002/hed.10316

Source DB:  PubMed          Journal:  Head Neck        ISSN: 1043-3074            Impact factor:   3.147


  7 in total

1.  Composite mandibulectomy: a novel animal model.

Authors:  Douglas R Sidell; Tara Aghaloo; Sotirios Tetradis; Min Lee; Olga Bezouglaia; Adam DeConde; Maie A St John
Journal:  Otolaryngol Head Neck Surg       Date:  2012-01-26       Impact factor: 3.497

2.  Pre-surgical assessment of mandibular bone invasion from oral cancer: comparison between different imaging techniques and relevance of radiologist expertise.

Authors:  Mario Silva; Eleonora I Zambrini; Gianfranco Chiari; Ilaria Montermini; Carmelinda Manna; Tito Poli; Davide Lanfranco; Enrico Sesenna; Elena Thai; Nicola Sverzellati
Journal:  Radiol Med       Date:  2016-06-04       Impact factor: 3.469

3.  Enhanced Mandibular Bone Repair by Combined Treatment of Bone Morphogenetic Protein 2 and Small-Molecule Phenamil.

Authors:  Jiabing Fan; Mian Guo; Choong Sung Im; Joan Pi-Anfruns; Zhong-Kai Cui; Soyon Kim; Benjamin M Wu; Tara L Aghaloo; Min Lee
Journal:  Tissue Eng Part A       Date:  2016-11-28       Impact factor: 3.845

4.  Defining the critical-sized defect in a rat segmental mandibulectomy model.

Authors:  Adam S DeConde; Matthew K Lee; Douglas Sidell; Tara Aghaloo; Min Lee; Sotirios Tetradis; Kyle Low; David Elashoff; Tristan Grogan; Ali R Sepahdari; Maie St John
Journal:  JAMA Otolaryngol Head Neck Surg       Date:  2014-01       Impact factor: 6.223

5.  Imaging of mandible invasion by oral squamous cell carcinoma using computed tomography, cone-beam computed tomography and bone scintigraphy with SPECT.

Authors:  Samer G Hakim; Henning Wieker; Thomas Trenkle; Peter Sieg; Jens Konitzer; Konstanze Holl-Ulrich; Hans-Christian Jacobsen
Journal:  Clin Oral Investig       Date:  2013-07-20       Impact factor: 3.573

6.  Prognostic value of matrix metalloproteinases in oral squamous cell carcinoma.

Authors:  Georgi Mishev; Elitsa Deliverska; Ruslan Hlushchuk; Nikolay Velinov; Daniel Aebersold; Felix Weinstein; Valentin Djonov
Journal:  Biotechnol Biotechnol Equip       Date:  2014-11-29       Impact factor: 1.632

Review 7.  Magnetic resonance imaging for diagnosis of mandibular involvement from head and neck cancers: a systematic review and meta-analysis.

Authors:  Chunjie Li; Wenbin Yang; Yi Men; Fanglong Wu; Jian Pan; Longjiang Li
Journal:  PLoS One       Date:  2014-11-14       Impact factor: 3.240

  7 in total

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