Hresko Andrii, Palyvoda Roman, Burtyn Olha, Chepurnyi Yurii, Kopchak Andrii, Helder Marco, Forouzanfar Tymour
Department of Maxilla-facial Surgery and Innovative Dentistry, O.O. Bogomolets National Medical University, 13, T. Shevchenko Blvd, Kyiv 01601, Ukraine.
Department of Head and Neck Tumors, National Cancer Institute, Kyiv, Ukraine.
J Oncol. 2022 Aug 9;2022:2148086. doi: 10.1155/2022/2148086. eCollection 2022.
Ameloblastoma is a slow-growing epithelial odontogenic neoplasm of the jaws with a high recurrence rate. The main treatment strategies for this lesion are radical or conservative surgical approaches. The aim of the present study was to analyze clinical presentations, histological types, and treatment strategies of recurrent ameloblastoma and to define its disease-free survival (DFS) rate.
Twenty-four cases of recurrent ameloblastomas, treated between January 2009 and July 2021, were enrolled in this study. Medical files from each patient, including gender, age, size of the lesion, localization, patient complaints, clinical manifestation, radiographic appearance, histological type, surgical management, and treatment results were reviewed and analyzed retrospectively.
Out of 69 operated primary ameloblastomas, the rate of recurrence was 35%. Out of 24 recurrent cases, 21 developed after conservative treatment and 3 after radical treatment. In most cases, recurrences were found in the mandible ( = 20). A unilocular pattern was predominant in radiographic examination (44%). Estimated 3-year DFS was 84.5 ± 4.8%, and the 5-year and 10-year DFS were 73.0 ± 6.3% and 43.9 ± 8.343.9 ± 8.3%, respectively.
Results obtained in the present retrospective study proved the necessity of long-term follow-up after both conservative and radical treatment approaches. The DFS median in our study was 8 years (95% CI 6 years-10 years). For recurrent cases, radical resection with histologically free margins after exact MRI determination of the ameloblastoma border within the soft tissues should be considered as the method of choice to avoid secondary recurrence.
成釉细胞瘤是一种生长缓慢的颌骨上皮性牙源性肿瘤，复发率高。该病变的主要治疗策略是根治性或保守性手术方法。本研究的目的是分析复发性成釉细胞瘤的临床表现、组织学类型和治疗策略，并确定其无病生存率（DFS）。
本研究纳入了2009年1月至2021年7月期间治疗的24例复发性成釉细胞瘤病例。回顾性分析每位患者的病历，包括性别、年龄、病变大小、部位、患者主诉、临床表现、影像学表现、组织学类型、手术治疗及治疗结果。
69例接受手术的原发性成釉细胞瘤中，复发率为35%。24例复发病例中，21例发生在保守治疗后，3例发生在根治性治疗后。大多数病例复发发生在下颌骨（n = 20）。影像学检查中以单房型为主（44%）。估计3年DFS为84.5±4.8%，5年和10年DFS分别为73.0±6.3%和43.9±8.3%。
本回顾性研究结果证明了保守和根治性治疗后长期随访的必要性。本研究中DFS中位数为8年（95%CI 6年 - 10年）。对于复发病例，在通过MRI精确确定软组织中成釉细胞瘤边界后，进行具有组织学阴性切缘的根治性切除应被视为避免二次复发的首选方法。
