Saber Tarek K, Hussein Hesham A, Mebeed Ali H, El Sebai Hesham I, Sami Ihab, Farahat Iman G
The Departments of Surgical Oncology, National Cancer Institute, Cairo University.
J Egypt Natl Canc Inst. 2009 Sep;21(3):219-27.
: The purpose of this study is to analyze the causes of Loco-regional failure in 51 patients with tumors of the oral cavity abutting the mandible.
This cross-sectional study (27 patients were operated upon in the retrospective section and 24 patients in the prospective section of the study) was done in the department of Surgical Oncology, National Cancer Institute, Cairo University, from January 2003 to January 2008. Fifty-one patients, with oral cavity cancerous lesions abutting the mandible, were operated upon by segmental mandibulectomy en-bloc with primary tumor resection in addition to modified radical or selective neck dissection according to the status of the cervical lymph nodes.
During a median follow-up of 2 years, 29 patients (56.8%) had local recurrences, the incidence of nodal recurrence after neck dissection was detected in 4 patients (7.8%). On multivariate analysis, tumor depth, tumor grade, oral mucosa, soft tissue and bone surgical margins in addition to metastatic lymphadenopathy were independent prognostic factors of loco-regional failure and disease-free survival.
Oral cavity cancers abutting the mandible should be treated with great caution by a multidisciplinary oncology team (resection and reconstruction surgeons) as it has a very aggressive biologic behavior. Negative intraoperative pathological margins should be attempted since this is the critical point for patients with cancers abutting the mandible? Further research on the biologic margin and genetic study is required.
Oral cavity cancer abutting the mandible - Predictors of loco-regional failure.
本研究旨在分析51例下颌骨毗邻口腔肿瘤患者局部区域复发的原因。
本横断面研究（回顾性部分纳入27例患者，前瞻性部分纳入24例患者）于2003年1月至2008年1月在开罗大学国家癌症研究所外科肿瘤学系进行。51例下颌骨毗邻口腔癌性病变的患者接受了节段性下颌骨切除联合原发肿瘤整块切除手术，并根据颈部淋巴结状况进行了改良根治性或选择性颈部清扫术。
在中位随访2年期间，29例患者（56.8%）出现局部复发，4例患者（7.8%）在颈部清扫术后出现淋巴结复发。多因素分析显示，肿瘤深度、肿瘤分级、口腔黏膜、软组织和骨手术切缘以及转移性淋巴结病是局部区域复发和无病生存的独立预后因素。
下颌骨毗邻的口腔癌应由多学科肿瘤团队（切除和重建外科医生）谨慎治疗，因为其具有非常侵袭性的生物学行为。应尝试获得阴性术中病理切缘，因为这是下颌骨毗邻癌症患者的关键要点？需要进一步开展生物学切缘和基因研究。
下颌骨毗邻口腔癌 - 局部区域复发的预测因素
