Bera Rathindra Nath, Tiwari Preeti
Senior Resident Department of Oral and Maxillofacial Surgery, Dental Institute Rajendra Institute of Medical Sciences, Ranchi Jharkhand, 834009, India.
Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences Institute of Medical Sciences, Banaras Hindu University, Varanasi Uttar Pradesh, 221001, India.
Oral Maxillofac Surg. 2024 Dec 30;29(1):22. doi: 10.1007/s10006-024-01321-3.
Ameloblastoma is a benign tumor originating from odontogenic epithelium with a global incidence of about 0.5 cases per million persons per year. The overall recurrence rate of ameloblastomas range from 55% -90%. In this retrospective study we have analyzed the factors associated with recurrence and recurrence free survival in ameloblastoma of the jaws.
Retrospective chart review of 10 years was done from records directory. All demographic data, data on diagnostic modalities, clinical presentations, radiology, management and histology were taken into consideration. Kaplan Meir estimator was used to evaluate recurrence rate and Cox regression analysis (univariate and multivariate) was used to evaluate the odds ratio to find out the possible factors influencing risk of recurrence and influence recurrence free survival. ROC curve (Receiver Operating Characteristic) was used to find out the optimal cut off point for size of the lesion in predicting recurrence. A p value of < 0.05 was considered statistically significant at 95% confidence interval.
A total of 75 patients had recurrence with a median follow up of 65 months. The overall 5 year RFS was 19.5%. Conventional ameloblastomas, cortical/ soft tissue invasion, conservative treatment and tumor size ≥ 4 cm were independent predictors of recurrence.
Aggressive treatment is preferred for conventional ameloblastomas ≥ 4 cm with cortical/ soft tissue invasion.
成釉细胞瘤是一种起源于牙源性上皮的良性肿瘤,全球发病率约为每年每百万人0.5例。成釉细胞瘤的总体复发率在55%至90%之间。在这项回顾性研究中,我们分析了颌骨成釉细胞瘤复发及无复发生存的相关因素。
从记录目录中对10年的病历进行回顾性查阅。纳入所有人口统计学数据、诊断方式、临床表现、放射学、治疗及组织学数据。采用Kaplan-Meier估计量评估复发率,采用Cox回归分析(单变量和多变量)评估比值比,以找出影响复发风险及无复发生存的可能因素。采用ROC曲线(受试者工作特征曲线)确定病变大小预测复发的最佳截断点。在95%置信区间,p值<0.05被认为具有统计学意义。
共有75例患者复发,中位随访时间为65个月。总体5年无复发生存率为19.5%。传统型成釉细胞瘤、皮质/软组织侵犯、保守治疗及肿瘤大小≥4 cm是复发的独立预测因素。
对于直径≥4 cm且伴有皮质/软组织侵犯的传统型成釉细胞瘤,建议采取积极治疗。