Department of Oral and Maxillofacial Surgery, the Clinical Research Institute and the Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Oral Dis. 2017 Nov;23(8):1058-1065. doi: 10.1111/odi.12687. Epub 2017 Sep 13.
Keratocystic odontogenic tumor (KCOT) demonstrates variable growth mechanisms and biologic behavior, partly due to origin and histology. We looked for the most contributing factors in predicting outcome of treatment.
We retrospectively reviewed 118 medical files of patients diagnosed with KCOT (by tissue biopsy before surgical treatment) with/without nevoid basal cell carcinoma syndrome (NBCCS) from 1995 to 2015. Data were recorded and analyzed statistically to determine the treatment-outcome correlation. KCOTs in NBCCS patients were termed "syndromic" and random KCOTs termed "sporadic."
Of 102 cysts, 32 were diagnosed with NBCCS. Sporadic KCOTs were significantly larger upon diagnosis (p < .017). Factors most indicative of postsurgical complications are older age (p < .011), upper jaw location, and size of lesion ≥9.5 cm². Sporadic KCOTs significantly increased the chances of complications approximately threefold (p < .043). Higher recurrence rate was significant in syndromic cysts (47%) compared to sporadic cysts (20%) (p < .009). Recurrence time was 3 years on average.
Postsurgical complications may be expected in: older patients, upper jaw location, extensive lesions, and sporadic KCOT. Most KCOT recurrence is diagnosed 3 years from treatment.
牙源性角化囊性瘤（KCOT）的生长机制和生物学行为具有变异性，部分原因是起源和组织学。我们寻找最有助于预测治疗结果的因素。
我们回顾性分析了 1995 年至 2015 年间经组织活检诊断为 KCOT（手术治疗前）的 118 例患者的医疗档案，其中包括有无神经嵴基底细胞癌综合征（NBCCS）的患者。记录数据并进行统计学分析，以确定治疗结果的相关性。NBCCS 患者的 KCOT 称为“综合征性”，随机 KCOT 称为“散发性”。
在 102 个囊肿中，有 32 个被诊断为 NBCCS。散发性 KCOT 在诊断时明显更大（p<.017）。术后并发症最具指示性的因素是年龄较大（p<.011）、上颌位置和病变大小≥9.5cm²。散发性 KCOT 使并发症的发生几率增加了约两倍（p<.043）。综合征性囊肿的复发率（47%）明显高于散发性囊肿（20%）（p<.009）。平均复发时间为 3 年。
术后并发症可能发生在：年龄较大的患者、上颌位置、广泛病变和散发性 KCOT。大多数 KCOT 复发是在治疗后 3 年诊断出来的。
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