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Pattern of Mandibular Bone Invasion as a Prognostic Factor.

Richard Pink1, Jaroslav Michálek2, Zdeněk Dvořák1,3

  • 1Department of Oral and Maxillofacial Surgery, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacky University Olomouc, 77900 Olomouc, Czech Republic.

Diagnostics (Basel, Switzerland)
|December 11, 2025
PubMed
Summary
This summary is machine-generated.

The pattern of mandibular bone invasion in oral squamous cell carcinoma (OSCC) impacts survival. Infiltrative invasion correlates with worse outcomes, while erosive invasion shows a protective association for overall survival (OS).

Keywords:
histopathologymandiblemandibular bone invasionoral squamous cell carcinomaprognosissurvival

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Area of Science:

  • Oncology
  • Oral and Maxillofacial Surgery
  • Radiology

Background:

  • Mandibular bone invasion is common in oral squamous cell carcinoma (OSCC), especially in lower alveolar, floor of mouth, and retromolar trigone tumors.
  • The prognostic significance of invasion patterns (erosive vs. infiltrative) is not well-defined.
  • Preoperative computed tomography (CT) diagnostic reliability for mandibular invasion requires evaluation.

Purpose of the Study:

  • To assess the prognostic relevance of erosive versus infiltrative mandibular invasion in OSCC.
  • To evaluate the diagnostic reliability of preoperative CT in detecting mandibular invasion.
  • To correlate invasion patterns with patient survival outcomes.

Main Methods:

  • Retrospective analysis of 83 OSCC patients with mandibular involvement undergoing surgical resection.
  • Histopathological classification of bone invasion as erosive or infiltrative.
  • Survival analysis using Kaplan-Meier and Cox regression; CT-histology agreement assessed with Cohen's kappa.

Main Results:

  • Mandibular invasion occurred in 50.6% of cases, with two-thirds being infiltrative.
  • Infiltrative invasion was associated with worse disease-specific survival (DSS) (aHR 1.93, p=0.042).
  • Erosive invasion showed a protective association with overall survival (OS) (aHR 0.39, p=0.041); CT-histology agreement was moderate (κ=0.45).

Conclusions:

  • The pattern of mandibular bone invasion significantly impacts OSCC patient survival.
  • Infiltrative invasion predicts poorer outcomes, while erosive invasion is linked to better OS, similar to no invasion.
  • Further multicenter validation is needed for routine clinical application in risk stratification.