Evaluation of bone resection margins of segmental mandibulectomy for oral squamous cell carcinoma

Publication date: Available online 28 March 2018
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): R.W.H. Smits, Ivo ten Hove, E.A.C. Dronkers, T.C. Bakker Schut, H. Mast, R.J. Baatenburg de Jong, E.B. Wolvius, G.J. Puppels, S. Koljenović
Resection margins are frequently studied in patients with oral squamous cell carcinoma and are accepted as a constant prognostic factor. While most evidence is based on soft tissue margins, reported data for bone resection margins are scarce. The aim of this retrospective study was to evaluate and determine the utility of surgical margins in bone resections for oral cavity squamous cell carcinoma (OCSCC). The status of bone resection margins and their impact on survival was investigated in patients who had undergone segmental mandibulectomy for OCSCC. Medical records were retrieved for the years 2000–2012; 127 patients were identified and included in the study. Tumour-positive bone resection margins were found in 21% of the patients. The 5-year overall survival was significantly lower in this group (P<0.005). Therefore, there is a need for intraoperative feedback on the status of bone resection margins to enable immediate additional resection where necessary. Although the lack of intraoperative methods for the evaluation of bone tissue has been addressed by many authors, there is still no reliable method for widespread use. Future research should focus on an objective, accurate, and rapid method of intraoperative assessment for the entire bone resection margin to optimize patient outcomes.



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