{"title":"荧光可视化引导手术改善了下颌骨鳞状细胞癌的局部控制。","authors":"Takamichi Morikawa, Takahiko Shibahara, Masayuki Takano","doi":"10.1016/j.joms.2024.08.011","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Local recurrence is common in mandibular squamous cell carcinoma (MSCC). Fluorescence visualization is a noninvasive technology that can detect oral epithelial dysplasia around MSCC, and it can potentially reduce local recurrence.</p><p><strong>Purpose: </strong>The purpose of this study was to measure and compare local control (LC) between fluorescence visualization-guided surgery (FVS) and conventional surgery for patients with Stages I or II MSCC.</p><p><strong>Study design, setting, sample: </strong>This retrospective cohort study was conducted at Tokyo Dental College, Chiba Hospital, or Chiba Dental Center. The medical records of MSCC patients from 2000 to 2021 were analyzed. Patients from any sex and 18 years of age or older with complete records who received surgery for mandibular SCC in the early stages were included in this study.</p><p><strong>Predictor variable: </strong>The predictor variable was operative treatment and was divided into 2 groups, conventional or FVS.</p><p><strong>Main outcome variables: </strong>The outcome variable is 5-year LC defined as no recurrence at or within 20 mm of the surgical site.</p><p><strong>Covariates: </strong>Covariates included demographic variables of age, sex, clinical and pathological characteristics, forms of resection, lifestyle, and quality of life.</p><p><strong>Analyses: </strong>Data analysis was performed by carrying out χ<sup>2</sup> tests. Survival outcome was performed by the Kaplan-Meier method, which was used to calculate and stratify the log-rank test; P values <.05 indicated statistical significance.</p><p><strong>Results: </strong>This study sample was composed of 56 subjects with a mean age of 68.5 years old (standard deviation 13.7), and 33 (58.9%) were female. There were 36 (64.3%) and 20 (35.7%) subjects in the conventional and FVS groups. The characteristics and quality of life did not differ significantly between the 2 groups. Five-year LC with FVS was statistically significantly higher than conventional surgery (P = .04, 94.4 vs 77.2%). Multivariate analysis for LC rate only identified FVS (P = .004; hazard ratio = 0.11, 95% confidence interval = 0.46, 0.88).</p><p><strong>Conclusion and relevance: </strong>On MSCC, LC was 94.4% in FVS versus 77.2% in conventional surgery. For MSCC at stages I and II, FVS was associated with improved LC.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":"89-101"},"PeriodicalIF":2.3000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Fluorescence Visualization-Guided Surgery Improves Local Control for Mandibular Squamous Cell Carcinoma.\",\"authors\":\"Takamichi Morikawa, Takahiko Shibahara, Masayuki Takano\",\"doi\":\"10.1016/j.joms.2024.08.011\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Local recurrence is common in mandibular squamous cell carcinoma (MSCC). Fluorescence visualization is a noninvasive technology that can detect oral epithelial dysplasia around MSCC, and it can potentially reduce local recurrence.</p><p><strong>Purpose: </strong>The purpose of this study was to measure and compare local control (LC) between fluorescence visualization-guided surgery (FVS) and conventional surgery for patients with Stages I or II MSCC.</p><p><strong>Study design, setting, sample: </strong>This retrospective cohort study was conducted at Tokyo Dental College, Chiba Hospital, or Chiba Dental Center. The medical records of MSCC patients from 2000 to 2021 were analyzed. Patients from any sex and 18 years of age or older with complete records who received surgery for mandibular SCC in the early stages were included in this study.</p><p><strong>Predictor variable: </strong>The predictor variable was operative treatment and was divided into 2 groups, conventional or FVS.</p><p><strong>Main outcome variables: </strong>The outcome variable is 5-year LC defined as no recurrence at or within 20 mm of the surgical site.</p><p><strong>Covariates: </strong>Covariates included demographic variables of age, sex, clinical and pathological characteristics, forms of resection, lifestyle, and quality of life.</p><p><strong>Analyses: </strong>Data analysis was performed by carrying out χ<sup>2</sup> tests. Survival outcome was performed by the Kaplan-Meier method, which was used to calculate and stratify the log-rank test; P values <.05 indicated statistical significance.</p><p><strong>Results: </strong>This study sample was composed of 56 subjects with a mean age of 68.5 years old (standard deviation 13.7), and 33 (58.9%) were female. There were 36 (64.3%) and 20 (35.7%) subjects in the conventional and FVS groups. The characteristics and quality of life did not differ significantly between the 2 groups. Five-year LC with FVS was statistically significantly higher than conventional surgery (P = .04, 94.4 vs 77.2%). Multivariate analysis for LC rate only identified FVS (P = .004; hazard ratio = 0.11, 95% confidence interval = 0.46, 0.88).</p><p><strong>Conclusion and relevance: </strong>On MSCC, LC was 94.4% in FVS versus 77.2% in conventional surgery. For MSCC at stages I and II, FVS was associated with improved LC.</p>\",\"PeriodicalId\":16612,\"journal\":{\"name\":\"Journal of Oral and Maxillofacial Surgery\",\"volume\":\" \",\"pages\":\"89-101\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Oral and Maxillofacial Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.joms.2024.08.011\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/8/23 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Oral and Maxillofacial Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.joms.2024.08.011","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/23 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
Fluorescence Visualization-Guided Surgery Improves Local Control for Mandibular Squamous Cell Carcinoma.
Background: Local recurrence is common in mandibular squamous cell carcinoma (MSCC). Fluorescence visualization is a noninvasive technology that can detect oral epithelial dysplasia around MSCC, and it can potentially reduce local recurrence.
Purpose: The purpose of this study was to measure and compare local control (LC) between fluorescence visualization-guided surgery (FVS) and conventional surgery for patients with Stages I or II MSCC.
Study design, setting, sample: This retrospective cohort study was conducted at Tokyo Dental College, Chiba Hospital, or Chiba Dental Center. The medical records of MSCC patients from 2000 to 2021 were analyzed. Patients from any sex and 18 years of age or older with complete records who received surgery for mandibular SCC in the early stages were included in this study.
Predictor variable: The predictor variable was operative treatment and was divided into 2 groups, conventional or FVS.
Main outcome variables: The outcome variable is 5-year LC defined as no recurrence at or within 20 mm of the surgical site.
Covariates: Covariates included demographic variables of age, sex, clinical and pathological characteristics, forms of resection, lifestyle, and quality of life.
Analyses: Data analysis was performed by carrying out χ2 tests. Survival outcome was performed by the Kaplan-Meier method, which was used to calculate and stratify the log-rank test; P values <.05 indicated statistical significance.
Results: This study sample was composed of 56 subjects with a mean age of 68.5 years old (standard deviation 13.7), and 33 (58.9%) were female. There were 36 (64.3%) and 20 (35.7%) subjects in the conventional and FVS groups. The characteristics and quality of life did not differ significantly between the 2 groups. Five-year LC with FVS was statistically significantly higher than conventional surgery (P = .04, 94.4 vs 77.2%). Multivariate analysis for LC rate only identified FVS (P = .004; hazard ratio = 0.11, 95% confidence interval = 0.46, 0.88).
Conclusion and relevance: On MSCC, LC was 94.4% in FVS versus 77.2% in conventional surgery. For MSCC at stages I and II, FVS was associated with improved LC.
期刊介绍：
This monthly journal offers comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery. Practice-applicable articles help develop the methods used to handle dentoalveolar surgery, facial injuries and deformities, TMJ disorders, oral cancer, jaw reconstruction, anesthesia and analgesia. The journal also includes specifics on new instruments and diagnostic equipment and modern therapeutic drugs and devices. Journal of Oral and Maxillofacial Surgery is recommended for first or priority subscription by the Dental Section of the Medical Library Association.
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