Predictors of carcinomatous invasion of the mandible
Identifieur interne : 000085 ( Istex/Curation ); précédent : 000084; suivant : 000086Predictors of carcinomatous invasion of the mandible
Auteurs : Terance T. Tsue [États-Unis] ; Timothy M. Mcculloch [États-Unis] ; Douglas A. Girod [États-Unis] ; David J. Couper [États-Unis] ; Ernest A. Weymuller Jr [États-Unis] ; Michael G. Glenn [États-Unis]Source :
- Head & Neck [ 1043-3074 ] ; 1994-03.
English descriptors
- KwdEn :
- Actual increase, Alveolar ridgehetromolar trigone, Bone invasion, Bone involvement, Bone scanning, Bony, Bony invasion, Bony involvement, Cancer history, Carcinoma, Carcinomatous invasion, Cell carcinoma, Chief complaint, Chief complaints, Clinical size estimate, Clinical size estimates, Cortical invasion, Cortical involvement, Craniomawcillofac surg, Decalcification specimens, Decision guide, Decision tree, Decision tree guide, Diagnostic workup, Edentulous patients, Exam, False negatives, Head neck, Head neck surg, Highest priority, Important part, Intraoral carcinoma, Invasion, John wiley sons, Lesion, Lymphatic channels, Magnetic resonance imaging, Mandible, Mandibular, Mandibular continuity, Mandibular cortex, Mandibular invasion, Mandibular invasion head neck, Mandibular invasion status, Mandibular involvement, Mandibular periosteum, Mandibular specimens, Mandibulectomy, Mcgregor, Multivariate, Multivariate analysis, Neck surgeon, Neck surgery, Negative mandibular invasion, Nodal, Oral cancer, Oral cavity, Osseous invasion, Osseous involvement, Pacific grove, Partitioning, Partitioning analysis, Pathologic, Pathologic exam, Physical exam, Positive mandibular invasion, Postoperative, Postoperative variables, Predictive, Predictive accuracy, Predictive association, Predictive variables, Preoperative, Preoperative evaluation, Preoperative variables, Present study, Previous studies, Primary tumor location, Primary tumor sites, Propensity, Reactive changes, Recent advances, Resection, Scan, Scan results, Sensory deficit, Specific category, Squamous, Squamous carcinoma, Squamous carcinomas, Squamous cell carcinoma, Study group, Study period, Surg, Surg gynecol obstet, Surgical, Surgical oncologic effectiveness, Tumor characteristics, Tumor fixation, Tumor size, Washington school.
- Teeft :
- Actual increase, Alveolar ridgehetromolar trigone, Bone invasion, Bone involvement, Bone scanning, Bony, Bony invasion, Bony involvement, Cancer history, Carcinoma, Carcinomatous invasion, Cell carcinoma, Chief complaint, Chief complaints, Clinical size estimate, Clinical size estimates, Cortical invasion, Cortical involvement, Craniomawcillofac surg, Decalcification specimens, Decision guide, Decision tree, Decision tree guide, Diagnostic workup, Edentulous patients, Exam, False negatives, Head neck, Head neck surg, Highest priority, Important part, Intraoral carcinoma, Invasion, John wiley sons, Lesion, Lymphatic channels, Magnetic resonance imaging, Mandible, Mandibular, Mandibular continuity, Mandibular cortex, Mandibular invasion, Mandibular invasion head neck, Mandibular invasion status, Mandibular involvement, Mandibular periosteum, Mandibular specimens, Mandibulectomy, Mcgregor, Multivariate, Multivariate analysis, Neck surgeon, Neck surgery, Negative mandibular invasion, Nodal, Oral cancer, Oral cavity, Osseous invasion, Osseous involvement, Pacific grove, Partitioning, Partitioning analysis, Pathologic, Pathologic exam, Physical exam, Positive mandibular invasion, Postoperative, Postoperative variables, Predictive, Predictive accuracy, Predictive association, Predictive variables, Preoperative, Preoperative evaluation, Preoperative variables, Present study, Previous studies, Primary tumor location, Primary tumor sites, Propensity, Reactive changes, Recent advances, Resection, Scan, Scan results, Sensory deficit, Specific category, Squamous, Squamous carcinoma, Squamous carcinomas, Squamous cell carcinoma, Study group, Study period, Surg, Surg gynecol obstet, Surgical, Surgical oncologic effectiveness, Tumor characteristics, Tumor fixation, Tumor size, Washington school.
Abstract
The preoperative assessment of mandibular invasion by oral or oropharyngeal squamous cell carcinoma poses a challenge for the head and neck surgeon. A study of 64 composite resection patients was performed to determine which variables in the patient's history, physical exam, and diagnostic workup had a predictive association with carcinomatous mandibular invasion. Four postoperative variables were included in this analysis. Thirty‐nine percent of the mandibular specimens demonstrated cancerous involvement. A multivariate recursive partitioning statistical analysis was performed to create a decision tree. Branching was based on the two statistically predictive variables: computed tomographic (CT) scan results and primary tumor location. The guide provides improved predictive accuracy with a 100% negative predictive value (NPV) and a 46% positive predictive value (PPV). This decision guide should help the surgeon provide accurate patient counseling, anticipate reconstructive needs, and maximize surgical oncologic effectiveness. © 1994 John Wiley & Sons, Inc.
Url:
DOI: 10.1002/hed.2880160204
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<affiliation><mods:affiliation>Correspondence address: Department of Otolaryngology‐Head and Neck Surgery, University of Washington School of Medicine RL‐30, Seattle, WA 98195</mods:affiliation>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Actual increase</term>
<term>Alveolar ridgehetromolar trigone</term>
<term>Bone invasion</term>
<term>Bone involvement</term>
<term>Bone scanning</term>
<term>Bony</term>
<term>Bony invasion</term>
<term>Bony involvement</term>
<term>Cancer history</term>
<term>Carcinoma</term>
<term>Carcinomatous invasion</term>
<term>Cell carcinoma</term>
<term>Chief complaint</term>
<term>Chief complaints</term>
<term>Clinical size estimate</term>
<term>Clinical size estimates</term>
<term>Cortical invasion</term>
<term>Cortical involvement</term>
<term>Craniomawcillofac surg</term>
<term>Decalcification specimens</term>
<term>Decision guide</term>
<term>Decision tree</term>
<term>Decision tree guide</term>
<term>Diagnostic workup</term>
<term>Edentulous patients</term>
<term>Exam</term>
<term>False negatives</term>
<term>Head neck</term>
<term>Head neck surg</term>
<term>Highest priority</term>
<term>Important part</term>
<term>Intraoral carcinoma</term>
<term>Invasion</term>
<term>John wiley sons</term>
<term>Lesion</term>
<term>Lymphatic channels</term>
<term>Magnetic resonance imaging</term>
<term>Mandible</term>
<term>Mandibular</term>
<term>Mandibular continuity</term>
<term>Mandibular cortex</term>
<term>Mandibular invasion</term>
<term>Mandibular invasion head neck</term>
<term>Mandibular invasion status</term>
<term>Mandibular involvement</term>
<term>Mandibular periosteum</term>
<term>Mandibular specimens</term>
<term>Mandibulectomy</term>
<term>Mcgregor</term>
<term>Multivariate</term>
<term>Multivariate analysis</term>
<term>Neck surgeon</term>
<term>Neck surgery</term>
<term>Negative mandibular invasion</term>
<term>Nodal</term>
<term>Oral cancer</term>
<term>Oral cavity</term>
<term>Osseous invasion</term>
<term>Osseous involvement</term>
<term>Pacific grove</term>
<term>Partitioning</term>
<term>Partitioning analysis</term>
<term>Pathologic</term>
<term>Pathologic exam</term>
<term>Physical exam</term>
<term>Positive mandibular invasion</term>
<term>Postoperative</term>
<term>Postoperative variables</term>
<term>Predictive</term>
<term>Predictive accuracy</term>
<term>Predictive association</term>
<term>Predictive variables</term>
<term>Preoperative</term>
<term>Preoperative evaluation</term>
<term>Preoperative variables</term>
<term>Present study</term>
<term>Previous studies</term>
<term>Primary tumor location</term>
<term>Primary tumor sites</term>
<term>Propensity</term>
<term>Reactive changes</term>
<term>Recent advances</term>
<term>Resection</term>
<term>Scan</term>
<term>Scan results</term>
<term>Sensory deficit</term>
<term>Specific category</term>
<term>Squamous</term>
<term>Squamous carcinoma</term>
<term>Squamous carcinomas</term>
<term>Squamous cell carcinoma</term>
<term>Study group</term>
<term>Study period</term>
<term>Surg</term>
<term>Surg gynecol obstet</term>
<term>Surgical</term>
<term>Surgical oncologic effectiveness</term>
<term>Tumor characteristics</term>
<term>Tumor fixation</term>
<term>Tumor size</term>
<term>Washington school</term>
</keywords>
<keywords scheme="Teeft" xml:lang="en"><term>Actual increase</term>
<term>Alveolar ridgehetromolar trigone</term>
<term>Bone invasion</term>
<term>Bone involvement</term>
<term>Bone scanning</term>
<term>Bony</term>
<term>Bony invasion</term>
<term>Bony involvement</term>
<term>Cancer history</term>
<term>Carcinoma</term>
<term>Carcinomatous invasion</term>
<term>Cell carcinoma</term>
<term>Chief complaint</term>
<term>Chief complaints</term>
<term>Clinical size estimate</term>
<term>Clinical size estimates</term>
<term>Cortical invasion</term>
<term>Cortical involvement</term>
<term>Craniomawcillofac surg</term>
<term>Decalcification specimens</term>
<term>Decision guide</term>
<term>Decision tree</term>
<term>Decision tree guide</term>
<term>Diagnostic workup</term>
<term>Edentulous patients</term>
<term>Exam</term>
<term>False negatives</term>
<term>Head neck</term>
<term>Head neck surg</term>
<term>Highest priority</term>
<term>Important part</term>
<term>Intraoral carcinoma</term>
<term>Invasion</term>
<term>John wiley sons</term>
<term>Lesion</term>
<term>Lymphatic channels</term>
<term>Magnetic resonance imaging</term>
<term>Mandible</term>
<term>Mandibular</term>
<term>Mandibular continuity</term>
<term>Mandibular cortex</term>
<term>Mandibular invasion</term>
<term>Mandibular invasion head neck</term>
<term>Mandibular invasion status</term>
<term>Mandibular involvement</term>
<term>Mandibular periosteum</term>
<term>Mandibular specimens</term>
<term>Mandibulectomy</term>
<term>Mcgregor</term>
<term>Multivariate</term>
<term>Multivariate analysis</term>
<term>Neck surgeon</term>
<term>Neck surgery</term>
<term>Negative mandibular invasion</term>
<term>Nodal</term>
<term>Oral cancer</term>
<term>Oral cavity</term>
<term>Osseous invasion</term>
<term>Osseous involvement</term>
<term>Pacific grove</term>
<term>Partitioning</term>
<term>Partitioning analysis</term>
<term>Pathologic</term>
<term>Pathologic exam</term>
<term>Physical exam</term>
<term>Positive mandibular invasion</term>
<term>Postoperative</term>
<term>Postoperative variables</term>
<term>Predictive</term>
<term>Predictive accuracy</term>
<term>Predictive association</term>
<term>Predictive variables</term>
<term>Preoperative</term>
<term>Preoperative evaluation</term>
<term>Preoperative variables</term>
<term>Present study</term>
<term>Previous studies</term>
<term>Primary tumor location</term>
<term>Primary tumor sites</term>
<term>Propensity</term>
<term>Reactive changes</term>
<term>Recent advances</term>
<term>Resection</term>
<term>Scan</term>
<term>Scan results</term>
<term>Sensory deficit</term>
<term>Specific category</term>
<term>Squamous</term>
<term>Squamous carcinoma</term>
<term>Squamous carcinomas</term>
<term>Squamous cell carcinoma</term>
<term>Study group</term>
<term>Study period</term>
<term>Surg</term>
<term>Surg gynecol obstet</term>
<term>Surgical</term>
<term>Surgical oncologic effectiveness</term>
<term>Tumor characteristics</term>
<term>Tumor fixation</term>
<term>Tumor size</term>
<term>Washington school</term>
</keywords>
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<front><div type="abstract" xml:lang="en">The preoperative assessment of mandibular invasion by oral or oropharyngeal squamous cell carcinoma poses a challenge for the head and neck surgeon. A study of 64 composite resection patients was performed to determine which variables in the patient's history, physical exam, and diagnostic workup had a predictive association with carcinomatous mandibular invasion. Four postoperative variables were included in this analysis. Thirty‐nine percent of the mandibular specimens demonstrated cancerous involvement. A multivariate recursive partitioning statistical analysis was performed to create a decision tree. Branching was based on the two statistically predictive variables: computed tomographic (CT) scan results and primary tumor location. The guide provides improved predictive accuracy with a 100% negative predictive value (NPV) and a 46% positive predictive value (PPV). This decision guide should help the surgeon provide accurate patient counseling, anticipate reconstructive needs, and maximize surgical oncologic effectiveness. © 1994 John Wiley & Sons, Inc.</div>
</front>
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