Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.
Head Neck. 2011 May;33(5):708-13. doi: 10.1002/hed.21530. Epub 2010 Nov 29.
Treatment of oral cavity cancer may require variable extent of mandibular resection. Marginal mandibulectomy is a controversial technique in providing oncologic resection margin. This study analyzes the efficacy of local oncologic control and the morbidity of marginal mandibulectomy in oral cavity carcinoma. Nononcologic complication of osteoradionecrosis is discussed.
A retrospective cohort study analyzed clinicopathologic features of 43 patients with oral cavity cancer who underwent marginal mandibulectomy. Histologic mandibular invasion was examined as a function of local control and contribution to osteoradionecrosis.
Bone invasion was present in 16.3% of patients with marginal mandibulectomy. Local control rates were 85.7% in the bone invasion group and 77.8% in the no bone invasion group (p = .7). Osteoradionecrosis rates were 16.7% and 17.6%, respectively (p = .96). There was no significant difference between the 2 groups.
Marginal mandibulectomy is oncologically sound in providing a safe resection margin in oral cavity cancer abutting or superficially invading the mandible.
口腔癌的治疗可能需要进行不同程度的下颌骨切除术。边缘下颌骨切除术在提供肿瘤学切除边界方面存在争议。本研究分析了边缘下颌骨切除术在口腔癌中的局部肿瘤控制效果和发病率。同时讨论了放射性骨坏死的非肿瘤性并发症。
回顾性队列研究分析了 43 例接受边缘下颌骨切除术的口腔癌患者的临床病理特征。组织学下颌骨侵犯被作为局部控制和放射性骨坏死的影响因素进行了检查。
边缘下颌骨切除术患者中有 16.3%存在骨侵犯。骨侵犯组的局部控制率为 85.7%，无骨侵犯组的局部控制率为 77.8%（p =.7）。放射性骨坏死的发生率分别为 16.7%和 17.6%（p =.96）。两组之间无显著差异。
边缘下颌骨切除术在为毗邻或浅部侵犯下颌骨的口腔癌提供安全的切除边界方面具有肿瘤学意义。
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