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CC BY-NC-ND 4.0 · South Asian J Cancer 2025; 14(02): 341-346
DOI: 10.1055/s-0044-1790286
Original Article
Head Neck Cancer Section

A Real-World Analysis of Oncological Outcomes in Patients with Oral Squamous Cell Carcinoma Requiring Marginal Mandibulectomy for Achieving Clear Surgical Margins

Authors

  • Hemant Nemade

    1   Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India

  • Abhinav Thaduri 

    1   Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India

  • Jonathan T. Gondi

    1   Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India

  • Sravan Kumar Chava

    1   Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India

  • Anil Kumar

    1   Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India

  • Pratheek Raj

    1   Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India

  • Uma Neelap

    1   Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India

  • L.M. Chandra Sekara Rao S.

    1   Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
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Abstract

Introduction

Marginal mandibulectomy (MM) offers a conservative alternative to segmental resections for patients with oral squamous cell carcinoma (OSCC) requiring clear margins without evident bone invasion. Despite its potential benefits, real-world outcomes related to surgical margins and oncological outcomes have not been studied sufficiently.

Methods

This ambispective cohort study analyzed 183 patients undergoing MM from January 2015 to March 2021 to achieve clear margins without clinical bone involvement. The primary objective is to assess the disease-free survival (DFS) in patients with OSCC requiring MM to achieve clear surgical margins, and the secondary objective is to assess the impact of microscopic bone involvement on these outcomes. Kaplan–Meier estimates facilitated the survival analysis.

Results

The cohort primarily comprised males (83.2%) with a median age of 50 years, the predominant subsite being the bucco-alveolar complex (94%). Microscopic bone involvement was found in 8.74% of patients. The distribution of surgical margins was 84.24% negative, 15.22% close, and 0.54% positive. The cohort's 3-year DFS and overall survival (OS) rates are 65 and 70%, respectively. Patients with microscopic bone involvement experienced lower DFS (odds ratio [OR] = 0.251, p = 0.013), and perineural invasion was also a significant negative prognostic factor for DFS (OR = 0.4, p = 0.01). Statistical analyses revealed significant differences in survival distributions based on bone involvement (p = 0.049).

Conclusion

While MM can achieve favorable surgical margins in selected OSCC patients, microscopic bone involvement compromises DFS. Given the low incidence of bone involvement and high rate of negative margins, more conservative approaches might be justified in select patients. However, these findings require further validation in a larger cohort.

Keywords

disease-free survival - marginal mandibulectomy - microscopic bone involvement - oncological outcomes - oral squamous cell carcinoma

Ethical Approval

The study was conducted in accordance with the Declaration of Helsinki. Confidentiality and anonymity of the participants were strictly maintained throughout the research process.


Supplementary Material



Publication History

Received: 20 July 2024

Accepted: 12 August 2024

Article published online:
05 September 2024

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