Tumor stage and resection margins not the mandibular invasion determines the survival in patients with cancers of oro-mandibular region

The role of tumor invasion into the mandible of oral squamous cell carcinoma

“…This effect might be the result of adequate resection margins in the bone, resulting in tumor negative resection margins, which has been shown to be a good prognostic factor in other studies (Binahmed et al 2007;Patel et al 2008). The data presented in this study is comparable with other publications relating to the topic of bone involvement in OSCC (Ash et al 2000;Dubner and Heller 1993;Pandey et al 2009;Patel et al 2008). In the past, radical en-bloc resections of the tumor and the mandible if closely related to the malignancy and regional lymph nodes were recommended in the belief that oral carcinomas invaded the mandible via periosteal lymphatic channels.…”

“…In addition, extent of nodal and clinical T stage, UICC stage, age, and recurrence (Table 4) were the most important predictors of overall survival in agreement with the literature (Chen et al 1999;Koo et al 2006;Levy et al 1991;Mücke et al 2009;Pandey et al 2009;Rogers et al 2009;Shah and Gil 2009). The type of reconstruction of patients also influenced survival, which has been recently found to be an independent factor of survival (Mücke et al 2010).…”

“…Most authors, including the present study, have demonstrated that invasion of the mandible by oral carcinoma does not influence outcome (Ash et al 2000;Dubner and Heller 1993;Pandey et al 2009;Patel et al 2008), while others have demonstrated evidence to the contrary (Jones et al 1997;Shaw et al 2004;Tankere et al 2002). In this study, the majority of mandible resections were segmental (44.9%) due to the tumor extent and bone invasion was present in virtually all except of 12% of these resections.…”

“…These advances in understanding of the mechanisms and pathogenesis of mandibular invasion by carcinoma have influenced surgical planning regarding the extent of bone resection required to achieve adequate margin resections (O'Brien et al 2003;Pandey et al 2009;Patel et al 2008;Shah and Gil 2009). This planning not only allows maintenance of the mandible and the alveolar nerve and its function in OSCC adjacent to the bone but also provides adequate safe margins of excision.…”

“…While sex and tumor location have been predictors of survival in other oral cavity cancer studies, they were not associated with survival in the univariate models and were thus not included in the multivariate analysis. Additional prognostic factors were added stepwise into the analysis, as they were associated with survival in the literature (Ash et al 2000;Dubner and Heller 1993;Mücke et al 2009;Pandey et al 2009;Patel et al 2008;Rogers et al 2009;Shah and Gil 2009). Only recurrence of tumor was associated with survival in the multivariate analysis controlling for tumor and N stage, UICC stage, extent of mandibulectomy, and age, with a hazard ratio of 1.459 (P = 0.039, 95% CI, 1.020-2.081).…”