Nathalie Tabchouri
University Pierre
Title: Imaging assessment of oral carcinoma with potential mandibular involvement
Biography
Biography: Nathalie Tabchouri
Abstract
The surgical management of oral squamous cell carcinoma invading the mandible remains controversial. The choice of the mandibular resection is based on the clinical and radiological extent of bone invasion. There are conflicting reports regarding the accuracy of tomography (CT) and magnetic resonance imaging (MRI).
Objectives : To retrospectively evaluate the accuracy of clinical exam, panoramic radiography, CT and MRI in predicting mandibular involvement by oral squamous cell carcinoma. The secondary aim was to establish the incidence of unnecessary segmental resections and insufficient mandibular resections.
Material and Methods : Ninety-two patients who presented with potential mandibular invasion by oral squamous cell carcinoma underwent CT and MR before surgery. The imaging results were correlated with histopathologic findings.
Results : A total of 40 patients underwent marginal resections and 52 underwent segmental resections. Histological bone invasion was present in 10 patients in the marginal resection group. Eight patients did not present with bone invasion in the segmental group. The sensitivity, the specificity and the accuracy for mandibular invasion were 77,5%, 93,9% and 84,9% for CT and 66,7%, 91,4% and 77,9% for MR imaging, respectively. 8.7% of all patients were undertreated. The incidence of unnecessary segmental resections was 10.9%. These over treated patients were found to be younger (p=0.016) and had less potentially malignant lesions (p=0.012).
Conclusions : In assessing the presence of mandibular invasion by OSSC, the combined use of CT and MR imaging is necessary but still insufficient for the treatment planning.