1. Effect of segmental versus marginal mandibular resection on local and lymph node recurrences in oral squamous cell carcinoma: is tumorous bone infiltration or location and resulting soft tissue recurrences a long-term problem?
- Author
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Ritschl LM, Niu M, Sackerer V, Claßen C, Stimmer H, Fichter AM, Wolff KD, and Grill FD
- Subjects
- Humans, Squamous Cell Carcinoma of Head and Neck pathology, Retrospective Studies, Mandible surgery, Mandible pathology, Lymph Nodes surgery, Lymph Nodes pathology, Lymphatic Metastasis pathology, Recurrence, Neoplasm Recurrence, Local surgery, Neoplasm Recurrence, Local pathology, Mouth Neoplasms surgery, Mouth Neoplasms pathology, Carcinoma, Squamous Cell pathology, Bone Neoplasms surgery, Bone Neoplasms pathology, Head and Neck Neoplasms pathology
- Abstract
Purpose: Oral squamous cell carcinomas (OSCCs) adjacent to the mandible or with clinically suspected bone infiltration are surgically treated either with marginal or segmental resections. This retrospective study compared both resections regarding local recurrence and lymph node recurrence or secondary lymph node metastases., Methods: All consecutive primary OSCC cases between January 2007 and December 2015 that underwent mandibular marginal or segmental resection were included. Rates of local and lymph node recurrences or secondary metastases and possible risk factors such as tumor localization according to Urken's classification were recorded., Results: In total, 180 patients with 85 marginal (group I) and 95 segmental (group II) mandibular resections were analyzed. The local recurrence rates were comparable between the groups (28.2% vs. 27.4%; p = 0.897). Lymph node recurrences or secondary metastases were higher in group I (9.4% (n = 8) vs. 6.2% (n = 6); p = 0.001). Tumor localization appears to affect the outcomes. Significantly fewer local and lymph node recurrences/metastases were found for Urken's classification SB and S calculated by two-proportion z-test (p = 0.014 and 0.056, respectively). Local recurrences mostly emerged from soft tissues, which should be resected more radically than the bones., Conclusion: While bone infiltration appears technically well controllable from an oncologic point of view, local recurrences and lymph node recurrences/metastases remain an issue. Regular clinical aftercare with imaging is crucial to detect recurrences., (© 2023. The Author(s).)
- Published
- 2023
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