Prediction of Maxillary Bone Invasion in Hard Palate/Upper Alveolus Cancer: A Multi-Center Retrospective Study

maxillary bone invasion (MBI) is not uncommon in hard palate or upper alveolus (HP/UA) cancer; however, there have been relatively few reports about the MBI of HP/UA cancer.

this was a multi-center retrospective study, enrolling 144 cases of HP/UA cancer. MBI was defined by surgical pathology or radiology follow-up. The multiple prediction models for MBI were developed in total cases and in cases having primary bone resection, using clinical and radiological variables.

computerized tomography (CT) alone predicted MBI, with an area under receiver operating curve (AUC) of 0.779 (95% confidence interval (CI) = 0.712-0.847). The AUC was increased in a model that combined tumor dimensions and clinical factors (male sex and nodal metastasis) (0.854 (95%CI = 0.790-0.918)). In patients who underwent ¹⁸fluorodeoxyglucose positron emission tomography/CT (PET/CT), the discrimination performance of a model including the maximal standardized uptake value (SUVmax) had an AUC of 0.911 (95%CI = 0.847-0.975). The scoring system using CT finding, tumor dimension, and clinical factors, with/without PET/CT SUVmax clearly distinguished low-, intermediate-, and high-risk groups for MBI.

using information from CT, tumor dimension, clinical factors, and the SUVmax value, the MBI of HP/UA cancer can be predicted with a relatively high discrimination performance.