Hemimandibulectomy and therapeutic neck dissection with radiotherapy in the treatment of oral squamous cell carcinoma involving mandible: a critical review of treatment protocol in the years 1994-2004



Year of publication 2010
Type Article in Periodical
Magazine / Source International Journal of Oral and Maxillofacial Surgery
MU Faculty or unit

Faculty of Medicine

Doi http://dx.doi.org/10.1016/j.ijom.2010.03.010
Field Surgery incl. transplantology
Keywords squamous cell carcinoma; oral cavity; retrospective study; tumour; actinotherapy; hemimandibulectomy; neck dissection
Description This retrospective non-randomized 10-year follow-up study compared 147 patients with squamous cell carcinoma (SCC) of the oral cavity requiring hemimandibulectomy, treated by surgical resection, therapeutic neck dissection and radiotherapy The 5-year survival rates were compared related to localization, size of the tumour, infiltration of locoregional lymph nodes, distant metastases, histopathological grading, radicality of surgery, and invasion of tumour into the mandible Occurrence of tumour relapse and its localization was studied The mean 5-year survival rate was 26% Patients with SCC of the mandibular alveolar process had higher rates, the lowest rates occurred in SCC of the buccal mucosa. Survival rate was significantly lower with insufficient resection of the tumour (85% relapse) An important number of patients with radical resection died within 3 months of surgery In almost 55% of the mandibles turnout was not present In 5% of infiltrated mandibles, dissemination into inferior alveolar nerve was proven Decreasing survival rate was seen with increasing size of tumour and higher histological grade Therapeutic neck dissection significantly reduces survival rate and increases the percentage of lymph node relapse. Elective neck dissection should be performed in SCC requiring hemimandibulectomy Primary reconstruction should reverse the high percentage of postoperative complication arising from increased radicality

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