'Doing as little as possible and as much as necessary' – Oncological efficacy of marginal mandibulectomy in resection of oral cavity cancers. (August 2019)

• Record Type: Journal Article
• Authors: Suresh, Sandeep; Thomas, Shaji; Janardhan, Deepak; Patil, Shirish; George, Nebu Abraham; Varghese, Bipin T.; Iype, Elizabeth Mathew; Rafi, Malu; George, Ciju K.
• Is Part Of: Oral oncology. Volume 95(2019)
• Page Start: 91
• Page End: 94
• Publication Date: 2019-08
• Subjects: Cancer of mouth -- Mandible -- Mandibular osteotomy -- Recurrence -- Survival; Mouth -- Cancer -- Periodicals; Mouth -- Tumors -- Periodicals; Mouth Diseases -- Periodicals; Mouth Neoplasms -- Periodicals; Bouche -- Cancer -- Périodiques; Bouche -- Tumeurs -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9943105
• DOI: 10.1016/j.oraloncology.2019.05.026
• Languages: English
• ISSNs: 1368-8375

Abstract

Highlights: Low recurrence rate following marginal mandibulectomy. Following neoadjuvant chemotherapy, marginal mandibulectomy has a role in organ preservation. For superficial lesions on the mandible, marginal mandibulectomy is an adequate procedure. Abstract: Background: In carefully selected oral cavity cancers, marginal mandibulectomy is an adequate procedure which achieves good disease control adhering to the principle of "doing as little as possible and as much as necessary". Methodology: This was a retrospective study done by reviewing the medical records of all patients who underwent marginal mandibulectomy for resection of oral cavity cancers in our institution during a period of 5 years. Data was collected from medical case records and analyzed. Results: 125 cases underwent marginal mandibulectomy for resection of oral cavity cancers. 88.5% of advanced oral cavity cancers that underwent neoadjuvant chemotherapy followed by marginal mandibulectomy are still disease free. The local recurrence rate was 10.4%. Among cases which recurred, 61.5% were in T2 stage of the disease and 30.8% recurred in buccal mucosa. For lesions on the mandible (26/125), the final histopathology showed bone infiltration in only 12% cases and among them only one recurred. Among 88/125 cases where the lesion was abutting mandible even after stretching mucosa, recurrence was noted only in 11.4% with 3-year overall survival of 79.3%. Conclusions: The low recurrence rate following marginal mandibulectomy in our study shows good locoregional control when performed for a lesion close to or abutting alveolar periosteum. In management of advanced oral cavity cancers, neoadjuvant chemotherapy followed by marginal mandibulectomy was effective in achieving significant locoregional control. For superficial lesions on the mandible, marginal mandibulectomy gives adequate margin clearance resulting in long term survival.