The prognostic impact of extent of bone invasion and extent of bone resection in oral carcinoma

OBJECTIVE: The prognostic impact of mandibular invasion by oral squamous cell carcinoma (SCC) is controversial. The objective of this study was to assess the effect that extent of bone invasion has on recurrence and survival in patients treated with marginal and segmental mandible resection. STUDY DESIGN: A retrospective cohort study of patients whose clinicopathologic information had been collected prospectively into a dedicated head and neck database. METHODS: Local control and disease-specific survival were retrospectively reviewed in 111 patients (median follow-up, 44 months) with oral SCC undergoing marginal or segmental mandibulectomy. RESULTS: Bone invasion was present in 46% of marginal and 94% of segmental resections. Five-year local control was similar following marginal (83%) and segmental mandibulectomy (86%). There was no correlation with presence or extent of bone invasion. Survival at 5 years was 71% and this correlated with bone invasion and involved margins (P < .05), but not with extent of mandible invasion or resection. CONCLUSIONS: Marginal mandibulectomy does not adversely alter outcome in selected patients with bone invasion provided margins are not compromised.