Diagnostic and therapeutic study of the strategy for mandibulectomy of squamous cell carcinoma of the lower gingiva by evaluating invasion to the mandible

• Negishi Akihide

  Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine

• Nobusawa Aiko

  Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine

• Ogawa Masaru

  Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine

• Takayama Yu

  Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine

• Makiguchi Takaya

  Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine

• Gomi Akinori

  Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine

• Miyazaki Hidetaka

  Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine

• Yokoo Satoshi

  Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine

Bibliographic Information

Other Title

• 下顎歯肉扁平上皮癌の下顎骨浸潤評価と切除法選択に関する診断学的・治療学的検討

Abstract

Squamous cell carcinoma of the lower gingiva (LGSCC) originates from thin alveolar mucosa and immediately invades mandibular bone. Evaluation of the type and depth of bone absorption by diagnostic imaging is important for planning mandibulectomy. This study retrospectively examined the validity of our strategy for mandibulectomy from the perspectives of histopathological grade of malignancy, mode of bone invasion as evaluated by imaging and histopathological bone invasion.<br>The participants comprised 37 patients with LGSCC who underwent mandibulectomy in the Department of Oral and Maxillofacial Surgery, Gunma University Hospital. The validity of the scope of mandibulectomy was verified by examination of preoperative diagnostic imaging and histopathological features of the resected specimen. As the infiltrative growth at the tumor-host border becomes more diffuse, bone absorption by imaging and intraosseous tumor invasion on histopathological examination are increased. The diagnostic accuracy of imaging is 75.7%. Differential imaging diagnosis of bone absorption caused by inflammation or tumor is difficult, and 21.6% of cases represent over-diagnosis. Our strategy for determining the extent of mandibulectomy is generally appropriate, but local recurrence developed in 1 case with histologically highly malignant type. It is suggested that cases thought to show diffuse invasion at the tumor-host border and bone invasion with a moth-eaten appearance require a more extended horizontal safety margin in the form of segmental or hemi-mandibulectomy.

Journal

• Toukeibu Gan

  Toukeibu Gan 40 (3), 318-323, 2014

  Japan Society for Head and Neck Cancer

Keywords

• Squamous cell carcinoma of the lower gingiva
• Bone invasion
• Imaging diagnosis
• Mandibulectomy

Details

• CRID: 1390001205222342656
• NII Article ID: 130004706087
• DOI: 10.5981/jjhnc.40.318
• ISSN: 18818382
• ISSN: 13495747
• Web Site: https://search.jamas.or.jp/link/ui/2015044038
• Text Lang: ja
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed