Lower Alveolar Carcinoma: Segmental v Marginal Resection

Abstract

\s=b\ Fifty-three patients were treated for squamous cell carcinoma of the lower alveolar ridge during a 24-year period. Comparison two-year survival rates and no evidence of disease (NED) figures were obtained for segmental and marginal resection of the mandible in these patients for each stage of the disease. Analysis of these two treatment modalities disclosed that marginal resection, especially when combined with radiation, is as effective in controlling disease in stages I and II and, possibly, in stage III. Stage IV carcinomas should be treated by combined segmental therapy. The comparatively high two-year NED rate for marginal resection found in this series suggests that this therapy should be considered as the initial form of therapy in selected patients with stage I and II disease. (Arch Otolaryngol 1983;109:578-582) Carci noma of the lower alveolar ridge (gums or alveolus) is a relatively common type of intraoral malignancy. It comprises approxi¬ mately 10% of all oral malignant neo¬ plasms.1 Its incidence varies from country to country with the highest known incidence in South India where

The prognostic and staging implications of bone invasion in oral squamous cell carcinoma

“…Whereas some authors have reported an association with adverse outcomes on univariate analysis, [3][4][5][6][7] other studies did not support this finding. [8][9][10] Furthermore, multivariate analyses taking into account potential confounding factors such as tumor size and involved margins have suggested that bone invasion is not an independent predictor of survival.…”

Imaging diagnosis for bone invasion by gingival carcinoma of the mandible: The value and the limitation

“…However, Totsuka et al [13] mentioned that a marginal resection of the mandibular bone was necessary to control CaMG when a bone defect was suspected, whether it was due to the tumor invasion or not, and other investigators have also reported similar findings [2,[14][15][16]. This fact shows that the low accuracy for the detection of the early bone invasion within the alveolus on diagnostic imaging does not become a large problem in clinical aspect of CaMG.…”

“…In contrast, they stressed that, if the tumor has spread beyond this area in each pattern, then a segmental resection should be performed to control the tumor. This opinion is accepted among many surgeons including Japanese surgeon who promote bone-preserving surgery [2,[14][15][16][17][18][19].…”

“…On the other hand, the supero-inferior extent of bone invasion in the mandible is one of the most important factors for decision of the extent of surgical resection of the mandible affected by the tumor [2,[13][14][15][16][17][18]. Totsuka et al [13] mentioned that a marginal resection should be performed for CaMG which radiologically showed no bone defect, an erosive bone defect without extending beyond the inferior alveolar canal, or an invasive bone defect within a superficial area of the alveolar bone.…”

Investigation of styrene/1‐hexene copolymerization by homogeneous and heterogeneous bisindenyl ethane zirconium dichloride catalyst system

“…Subsequent studies examining the prognostic significance of bone invasion have shown conflicting results. Whereas some authors have reported an association with adverse outcomes on univariate analysis,3‐7 other studies did not support this finding 8‐10. Furthermore, multivariate analyses taking into account potential confounding factors such as tumor size and involved margins have suggested that bone invasion is not an independent predictor of survival 4‐6.…”