Maxillary Alveolar Carcinoma: Risk of Recurrence and its Relation with Prognostic Indicators

Zubair Durrani
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Abstract

Background: Maxillary Alveolar carcinoma is a relatively uncommon entity with occurrence reported between 3.5 to 10% of all oral cancers. Recurrence when occurs locally are particularly difficult to treat due to the close proximity of this region to the infratemporal fossa and the base of skull. There is also a debate when to perform elective neck dissection in these patients. Objectives: The aim of this study was to identify cases with recurrence and correlate its association with various prognostic factors and disease free survival in these patients. Methodology: Overall, 15 cases were identified with maxillary alveolar carcinomas that were treated between 2011 to 2015. Eight of these cases were Squamous cell carcinomas, 5 Adeno carcinomas and 2 Adenocystic carcinomas. T stages, N stage, grade of tumor, surgical margin involvement by the tumor, presence of perineural and lymphovascular invasion were identified as prognostic indicators. The chi-square and Pearson correlation tests were applied to analyze the association between recurrence and these prognostic factors. Results: Recurrence developed in 3 SCC (37.5%) and 1 ADC (20%) patient during the three years period following the treatment. Among the SCC patients, 2 recurrences were local and 1 regional. Recurrence was found to have a strong positive correlation with T stage (r=0.330, p=0.271), surgical margin involvement (r=0.575, p=0.566) and three years disease free survival (r=0.959, p=0.000). A weak positive correlation was also established with tumor grade (r=0.155, p=0.0613) and perineural invasion (r=0.149, p =0.725).
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上颌牙槽癌:复发风险及其与预后指标的关系
背景:上颌牙槽癌是一种相对罕见的疾病,据报道其发生率在所有口腔癌的3.5%至10%之间。局部复发尤其难以治疗,因为该区域靠近颞下窝和颅底。在这些患者中,何时进行选择性颈部清扫也存在争议。目的:本研究的目的是确定复发病例,并将其与这些患者的各种预后因素和无病生存相关联。方法:我们收集了2011 - 2015年间治疗的15例上颌牙槽癌患者。其中8例为鳞状细胞癌,5例为腺癌,2例为腺囊癌。T分期、N分期、肿瘤分级、肿瘤累及手术切缘、有无神经和淋巴血管浸润被确定为预后指标。应用卡方检验和Pearson相关检验分析复发率与这些预后因素之间的关系。结果:3例SCC(37.5%)和1例ADC(20%)患者在治疗后3年内复发。2例局部复发,1例区域性复发。复发与T分期(r=0.330, p=0.271)、手术缘受累(r=0.575, p=0.566)、3年无病生存率(r=0.959, p=0.000)呈正相关。与肿瘤分级(r=0.155, p=0.0613)和周围神经浸润(r=0.149, p= 0.725)呈弱正相关。
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