Recurrence-free survival and prognostic factors of odontogenic keratocyst: a single-center retrospective cohort

França, Glória Maria de; Silva, Luíza Borba Antunes da; Mafra, Rodrigo Porpino; Silva, Weslay Rodrigues da; Lima, Kênio Costa de; Galvão, Hébel Cavalcanti

doi:10.1007/s00405-020-06229-8

Cited by 8 publications

(8 citation statements)

References 24 publications

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“…38 On the other hand, de França et al found a similar frequency of relapse between unilocular and multilocular OKCs (44.4% compared to 55.6%), and did not show that locularity of the cyst has any significant influence on relapse. 39 The ambiguity of our own results and of the published data suggests that, in essence, there may be a combination of several factors having an impact on OKC recurrence, including size, locularity and association with dentition. Thus, it seems reasonable that future research should focus on testing these factors -taken collectively or in different combinations.…”

Section: Discussionmentioning

confidence: 55%

“…Previous studies have demonstrated that COX-2 plays an important role in the biological regulation of OKC epithelial lining, 41 and it has been shown to be partially involved in the mechanism of OKC progression. 39 The COX-2 is known to increase the level of Bcl-2, thus suppressing apoptosis. 44 Moreover, COX-2-dependent prostaglandins have been implicated in the induction of matrix metalloproteinases (MMPs), which are important in matrix degradation during tumor growth and invasion, and induction of angiogenesis.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic relevance of clinicopathological factors in sporadic and syndromic odontogenic keratocysts: A comparative study

Kisielowski¹,

Drozdzowska²,

Szuta³

et al. 2022

Adv Clin Exp Med

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Background. Current evidence suggests that nevoid basal cell carcinoma syndrome (NBCCS)-associated odontogenic keratocysts (OKCs) exhibit more aggressive clinical behavior and a higher tendency to relapse. The prognostic efficacy of various markers in sporadic and syndromic OKCs is unclear, and so are the results of studies on the usefulness of immunohistochemistry in distinguishing syndromic from sporadic OKCs.Objectives. This retrospective study aimed to compare the prognostic relevance of various clinicoradiological and histopathological features, as well as the immunoexpression of COX-2, Bcl-2, proliferating cell nuclear antigen (PCNA), p53, Ki-67, osteoprotegerin (OPG), receptor activator of nuclear factor κ B (RANK) and receptor activator of nuclear factor κ B ligand (RANKL), as well as RANKL/OPG balance between sporadic and syndromic OKCs, and to test their utility in distinguishing the 2 types of OKC. Materials and methods.We compared the immunoexpression of the aforementioned markers between 31 sporadic and 12 syndromic OKCs, and tested clinicopathological findings and levels of immunostaining against recurrence.Results. We found a significant association between NBCCS and OKC recurrence. There were significant differences in PCNA, p53 and OPG immunoexpression between sporadic and syndromic OKCs. We also found that recurrent sporadic OKCs were significantly larger and markedly more often associated with cortical perforation. Recurrent sporadic OKCs exhibited COX-2 upregulation, but we failed to demonstrate its prognostic relevance. Recurrent syndromic OKCs showed a markedly higher RANKL > OPG ratio. Conclusions.The NBCCS-associated OKCs are significantly more prone to recur than their sporadic counterparts. Larger size and radiological signs of cortical perforation in sporadic OKCs may indicate a higher risk of recurrence. The COX-2 is upregulated in recurrent sporadic OKCs, whereas recurrent syndromic OKCs exhibit higher RANKL and lower OPG expression; however, these findings have no prognostic relevance. The immunoexpression of p53, PCNA and OPG may help to distinguish syndromic from sporadic OKCs.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Prognostic relevance of clinicopathological factors in sporadic and syndromic odontogenic keratocysts: A comparative study

Kisielowski¹,

Drozdzowska²,

Szuta³

et al. 2022

Adv Clin Exp Med

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“…Histopathological features of daughter cysts and epithelial budding are strongly linked with high recurrence and aggressive behavior as reported by multiple large studies (Cunha et al, 2016;de França et al, 2021;Fidele et al, 2019;Myoung et al, 2001;Razavi et al, 2014). The presence of these features should alarm the pathologist to inform the surgeon and advise more aggressive management.…”

Section: Histopathological Parametersmentioning

confidence: 79%

“…Based on the findings of the included studies, parameters that were reported to be significantly related to OKC recurrence included age (with variable age categories) (MacDonald et al, 2013; Myoung et al, 2001; Selvi et al, 2012; Titinchi & Nortje, 2012), large (Kaczmarzyk et al, 2018; Tabrizi et al, 2014; Yagyuu et al, 2008), multilocular lesions (Fidele et al, 2019; Kaczmarzyk et al, 2018; Tabrizi et al, 2014; Yagyuu et al, 2008) that perforate through the cortex (Fidele et al, 2019; Kaczmarzyk et al, 2018) with dentition associated within the lesion (Cunha et al, 2016; Fidele et al, 2019). The presence of daughter cysts (Cunha et al, 2016; de França et al, 2021; Fidele et al, 2019; Myoung et al, 2001; Razavi et al, 2014) and epithelial budding (Cottom et al, 2012; Cunha et al, 2016; Razavi et al, 2014) were also significantly associated with high recurrence as were histochemical markers Ki67 index (Kuroyanagi et al, 2009; Selvi et al, 2012) and AgNOR count (Chandrashekar et al, 2020; Selvi et al, 2012).…”

Section: Resultsmentioning

confidence: 99%

“…The quality of the studies ranged between 3 and 5 with the overall level of evidence is considered to be low. The majority of studies (19 studies) were of level 4 evidence on the CEBM guidelines (Bello, 2016; Berge et al, 2016; Chirapathomsakul et al, 2006; Cunha et al, 2016; Doll et al, 2018; Fidele et al, 2019; Giovacchini et al, 2020; Habibi et al, 2007; Kaczmarzyk et al, 2018; Kuroyanagi et al, 2009; MacDonald et al, 2013; Myoung et al, 2001; Naruse et al, 2017; Razavi et al, 2014; Selvi et al, 2012; Tabrizi et al, 2014; Titinchi & Nortje, 2012; Yagyuu et al, 2008; Zhao et al, 2012) while two studies were of level 3 evidence (Cottom et al, 2012; de França et al, 2021) and two of level 5 evidence (Chandrashekar et al, 2020; Naz et al, 2015). No prospective controlled trials or cohort studies were conducted in the literature on this topic.…”

Section: Resultsmentioning

confidence: 99%

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Novel recurrence risk stratification of odontogenic keratocysts: A systematic review

Titinchi

2021

Oral Diseases

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The aim of this study was to identify all clinical, radiological, histopathological, and immunohistochemical features associated with recurrence of odontogenic keratocysts (OKCs) in the literature and formulate a recurrence risk stratification based on these findings. A search was performed in PubMed/Medline, Scopus, Web of Science, Google Scholar and Cochrane databases for clinical and laboratory studies reporting on clinico‐pathological features that led to OKC recurrences for the period 2000 to 2020. Twenty‐three studies were identified and analyzed qualitatively. A total of 2064 OKCs were included of which 439 OKCs were recurrent with a mean follow‐up period of 46.7 months. Significantly associated parameters with OKC recurrence included age (variable age categories), large (>4 cm), multilocular lesions with cortical perforation, association with dentition, presence of daughter cysts, and epithelial budding. Immunohistochemical markers including high Ki67 index and AgNOR count were also implicated. A recurrence risk stratification was formulated based on these findings. Although the level of evidence from the included studies was low, there was considerable evidence that the clinico‐pathological parameters identified were linked with higher OKC recurrence. The surgeon, radiologist, and pathologist should aim to identify these features when making a diagnosis so as to determine the appropriate management regime and prevent recurrences.

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2022

Shear's Cysts of the Oral and Maxillofacial Regions

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Recurrence-free survival and prognostic factors of odontogenic keratocyst: a single-center retrospective cohort

Cited by 8 publications

References 24 publications

Prognostic relevance of clinicopathological factors in sporadic and syndromic odontogenic keratocysts: A comparative study

Prognostic relevance of clinicopathological factors in sporadic and syndromic odontogenic keratocysts: A comparative study

Novel recurrence risk stratification of odontogenic keratocysts: A systematic review

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