Ameloblastoma: 25 Year Experience at a Single Institution

Area of Science:

• Oral and Maxillofacial Surgery
• Oncology
• Pathology

Background:

• Ameloblastoma is a rare, locally aggressive odontogenic neoplasm, comprising less than 1% of head and neck tumors.
• Recent literature indicates surgical approach and histologic patterns are key prognostic factors.

Purpose of the Study:

• To compare clinical presentation, management, and outcomes of ameloblastoma patients with existing literature.
• To identify prognostic determinants for ameloblastoma recurrence and outcomes.

Main Methods:

• Retrospective review of 54 pathologically confirmed ameloblastoma cases diagnosed between 1990 and 2015 at a single institution.
• Data collection included demographics, clinical/imaging findings, management, histology, margin status, follow-up, recurrence, and mortality.
• Statistical analysis using log-rank test, proportional hazard model, and Fisher exact test to evaluate recurrence risk factors.

Main Results:

• Recurrence was observed in 24% (13/54) of patients.
• Radical resection (6.1% recurrence) was associated with significantly lower recurrence rates compared to limited surgery (52% recurrence, p=0.002).
• Positive surgical margins showed a trend towards higher recurrence (p=0.054); follicular ameloblastoma also showed a trend (p=0.35). Two cases transformed into ameloblastic carcinoma. No disease-related mortality was recorded.

Conclusions:

• Radical surgical resection is the strongest predictor of tumor clearance and is critical for managing ameloblastoma.
• The surgical approach significantly impacts recurrence risk, emphasizing the need for complete tumor extirpation.
• This study reinforces the importance of aggressive surgical management in improving outcomes for ameloblastoma patients.