Resident, Department of Surgery, Division of Oral and Maxillofacial Surgery, Emory University School of Medicine, Atlanta, GA, USA.
Resident, Department of Surgery, Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2019 Apr;127(4):282-288. doi: 10.1016/j.oooo.2018.12.001. Epub 2018 Dec 14.
The aim of this study was to answer the following clinical questions: Among patients treated for odontogenic keratocysts (OKCs), what is the overall 5-year disease-free rate, and what factors are associated with disease recurrence?
We implemented a multicenter retrospective cohort study composed of patients presenting for the evaluation and management of previously untreated OKCs. The predictor variables were grouped into demographic, medical, radiographic, and operative categories. The primary outcome variable was time to lesion recurrence. Data analyses were performed by using bivariate analysis and univariate or multivariate Cox proportional hazards models.
The study sample was composed of 231 OKCs. Of these, 57 (24.7%) were treated with decompression with residual cystectomy, 86 (37.2%) with enucleation without adjuvant therapy, and 78 (33.8%) with enucleation with peripheral ostectomy. There were 44 recurrences (19%), with a median time to recurrence of 26.7 months (range 15.8-49.8).
This multicenter study is the largest study analyzing disease recurrence after treatment of OKCs by using appropriate statistical analysis for a time-to-event outcome (disease recurrence). The 5-year disease-free estimate was 29%. Mandibular lesions, multilocular lesions, and lesions treated with decompression and residual cystectomy were associated with recurrence.
本研究旨在回答以下临床问题：在接受牙源性角化囊肿（OKC）治疗的患者中，总体 5 年无疾病生存率是多少，哪些因素与疾病复发相关？
我们进行了一项多中心回顾性队列研究，纳入了接受未经治疗的 OKC 评估和管理的患者。预测变量分为人口统计学、医学、影像学和手术类别。主要结局变量为病变复发时间。数据分析采用双变量分析以及单变量或多变量 Cox 比例风险模型进行。
研究样本由 231 个 OKC 组成。其中，57 个（24.7%）采用减压联合残余囊切除术治疗，86 个（37.2%）采用囊内切除术且不辅助治疗，78 个（33.8%）采用囊内切除术联合骨切除术。有 44 例（19%）复发，中位复发时间为 26.7 个月（范围 15.8-49.8）。
这项多中心研究是分析 OKC 治疗后疾病复发情况的最大研究，采用了适当的时间事件结局（疾病复发）的统计分析方法。5 年无疾病生存率估计值为 29%。下颌骨病变、多房性病变以及采用减压联合残余囊切除术治疗的病变与复发相关。
