Clinical, Radiological and Pathological Co-Relation Of Mandibular Involvement In Cancers Of Oral Cavity
Keywords:
Squamous cell carcinoma, oral cancer, mandibular invasion, Staging, investigation
Abstract
Introduction: In Head and neck squamous cell carcinoma (HNSCC), the clinical assessment of mandibular involvement is often inaccurate and unreliable. Involvement of mandible, upstage the disease to stage IV. Investigations like orthopantogram, computed tomography (CT), magnetic resonance imaging (MRI), bone scintigraphy etc have been evaluated by different authors for involvement of mandible with wide variation in results. This has prompted us to correlate clinically, radiological, and pathological to formulate the appropriate protocol for evaluation of mandibular involvement.Materials And Methods: It is a prospective and a retrospective study. In prospective part, all patients with clinical and radiological confirmation of mandibular involvement were undergone mandibulectomy. The histologic findings of mandibular bone involvement were then compared with the radiographic findings, along with tumor location, stage, and grade. For retrospective study, the medical records of patients, who had under gone mandibulectomy as a part of treatment of oral cavity cancers were analyzed and correlated. Results: In the present study, the bone involvement was found in 69% clinically, 40.5% by Orthopantogram, 39.6% by CT scan and 54% on MRI scan. The histological confirmation of bone involvement was evaluated in all the above cases. It was found that 22% of clinically positive, 46% of OPG positive patients, 52% of CT scan positive and 46% of MRI positive had invasionConclusion: There is no single modality of investigation which appears to have high specificity and sensitivity. Combination of different modalities increases the both sensitivity and specificity. In our study clinical examination along with high resolution CT scan has the acceptable sensitivity and specificity which may be applied for better results.References
1. Greenlee RT, Hill-Harmon MB, Murray T, Thun M. Cancer statistics, 2001. CA Cancer J Clin. 2001 Jan-Feb;51 (1):15-36.
2. Tartaro S, Santagata M, Capone R, Siniscalchi G, Colella G. Oral cancer. Retrospective analysis of 118 cases: Minerva Stomatol. 2004 Mar; 53(3):87-91.
3. Tsue TT, McCulloch TM, Girod DA, Couper DJ, Weymuller EA, Glenn MG: Predictors of carcinomatous invasion of the mandible. Head Neck 1994: 16:116–126.
4. Mehrotra R, Singh M, Kumar D, Pandey AN, Gupta RK, Sinha US. Age Specific incidence rate and pathological spectrum of oral cancer in Allahabad. Indian Journal of Medical Sciences, Volume 57, Number 9, Sept 2003: 400-404.
5. Parkin M, Pisani P, Ferlay J.CA Cancer J Clin: 1999;49:33-64.
6. Yeole B, Sankaranarayanan R, Sunny M, Swaminathan R, Parkin D. Survival from head and neck cancer in Mumbai (Bombay), India; Cancer. 2000, 89(2): 437-444.
7. ICMR. National Cancer Registry Programme, Consolidated report of the population based cancer registries, 1997 (Unpublished). Indian Council of Medical Research, New Delhi. November 2001.
8. Chandra SS, Gupta PD, Patel JD, Jhala JT,•Dhebar M. Mandibular invasion in oral cancers. Eur Arch Otorhinolaryngol (2000) 257 :343–346
9. Bahadur S. Mandibular involvement in oral cancer. J Laryngol Otol 1990: 104: 968-71.
10. Weisman RA. Kimmelman CP. Bone scanning in the assessment of mandibular invasion by oral cavity carcinomas. Laryngoscope 1982; 92: 1 -4
11. Rao LP, Das SR, Mathews A, Naik BR, Chacko B, Pandey M. Mandibular invasion in oral squamous cell carcinoma: investigation by clinical examination and orthopantomogram. Int J Oral Maxillofac Surg. 2004 Jul; 33(5):454-7.
12. Close LG, Burns DK, Merkel M. Schaefer SD. Computed tomogrciphy in the assessment of mandibular invasion by intraotal carcinoma. Ann Otol Rhinol Laryngol 1986; 95: 383-8.
13. Shaha AR. Preoperative evaluation of the mandible in patients with carcinoma of the floor of mouth. Head Neck 1991; 13: 398-402
14. Lane AP, Buckmire RA, Mukherji SK, Pillsbury HC 3rd, Meredith SD. Use of computed tomography in the assessment of mandibular invasion in carcinoma of the retromolar trigone. Otolaryngol Head Neck Surg. 2000 May; 122(5):673-7.
15. Brown JS, Griffith JF, Phelps PD, Brown RM. A comparison of different imaging modalities and direct inspection after periosteal stripping in predicting the invasion of the mandible by oral squamous cell carcinoma. Br 3 Oral Maxillofac Sutg 1994 32: 347-59.
16. Huntley TA, Busrnanis L, Desmond P, Wiesenfeld O. Mandibular invasion by squamous cell carcinoma: a computer tomographie and histological study. Br J Oral Maxillofac Surg 1996; 34: 69-74.
17. Heissler E, Steinkamp HJ, Heim T, Zwicker C, Felix R, Bier J. Value of magnetic resonance imaging in staging carcinomas of the oral cavity and oropharynx. 1nt J Oral Maxillofac Surg 1994; 23: 22-7.
2. Tartaro S, Santagata M, Capone R, Siniscalchi G, Colella G. Oral cancer. Retrospective analysis of 118 cases: Minerva Stomatol. 2004 Mar; 53(3):87-91.
3. Tsue TT, McCulloch TM, Girod DA, Couper DJ, Weymuller EA, Glenn MG: Predictors of carcinomatous invasion of the mandible. Head Neck 1994: 16:116–126.
4. Mehrotra R, Singh M, Kumar D, Pandey AN, Gupta RK, Sinha US. Age Specific incidence rate and pathological spectrum of oral cancer in Allahabad. Indian Journal of Medical Sciences, Volume 57, Number 9, Sept 2003: 400-404.
5. Parkin M, Pisani P, Ferlay J.CA Cancer J Clin: 1999;49:33-64.
6. Yeole B, Sankaranarayanan R, Sunny M, Swaminathan R, Parkin D. Survival from head and neck cancer in Mumbai (Bombay), India; Cancer. 2000, 89(2): 437-444.
7. ICMR. National Cancer Registry Programme, Consolidated report of the population based cancer registries, 1997 (Unpublished). Indian Council of Medical Research, New Delhi. November 2001.
8. Chandra SS, Gupta PD, Patel JD, Jhala JT,•Dhebar M. Mandibular invasion in oral cancers. Eur Arch Otorhinolaryngol (2000) 257 :343–346
9. Bahadur S. Mandibular involvement in oral cancer. J Laryngol Otol 1990: 104: 968-71.
10. Weisman RA. Kimmelman CP. Bone scanning in the assessment of mandibular invasion by oral cavity carcinomas. Laryngoscope 1982; 92: 1 -4
11. Rao LP, Das SR, Mathews A, Naik BR, Chacko B, Pandey M. Mandibular invasion in oral squamous cell carcinoma: investigation by clinical examination and orthopantomogram. Int J Oral Maxillofac Surg. 2004 Jul; 33(5):454-7.
12. Close LG, Burns DK, Merkel M. Schaefer SD. Computed tomogrciphy in the assessment of mandibular invasion by intraotal carcinoma. Ann Otol Rhinol Laryngol 1986; 95: 383-8.
13. Shaha AR. Preoperative evaluation of the mandible in patients with carcinoma of the floor of mouth. Head Neck 1991; 13: 398-402
14. Lane AP, Buckmire RA, Mukherji SK, Pillsbury HC 3rd, Meredith SD. Use of computed tomography in the assessment of mandibular invasion in carcinoma of the retromolar trigone. Otolaryngol Head Neck Surg. 2000 May; 122(5):673-7.
15. Brown JS, Griffith JF, Phelps PD, Brown RM. A comparison of different imaging modalities and direct inspection after periosteal stripping in predicting the invasion of the mandible by oral squamous cell carcinoma. Br 3 Oral Maxillofac Sutg 1994 32: 347-59.
16. Huntley TA, Busrnanis L, Desmond P, Wiesenfeld O. Mandibular invasion by squamous cell carcinoma: a computer tomographie and histological study. Br J Oral Maxillofac Surg 1996; 34: 69-74.
17. Heissler E, Steinkamp HJ, Heim T, Zwicker C, Felix R, Bier J. Value of magnetic resonance imaging in staging carcinomas of the oral cavity and oropharynx. 1nt J Oral Maxillofac Surg 1994; 23: 22-7.
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2017-12-17
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