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Lower alveolar carcinoma. Segmental v marginal resection.
Archives of Otolaryngology (Chicago, Ill. : 1960)
|September 1, 1983
Summary
Marginal resection, with or without radiation, is effective for early-stage (I and II) squamous cell carcinoma of the lower alveolar ridge, offering comparable outcomes to segmental resection. Stage IV requires segmental therapy.
Area of Science:
- Oncology
- Oral Surgery
- Head and Neck Cancer
Background:
- Squamous cell carcinoma (SCC) of the lower alveolar ridge is a significant oral malignancy.
- Treatment decisions involve balancing oncologic control with functional preservation of the mandible.
- Surgical approaches include segmental and marginal resection, each with distinct implications.
Purpose of the Study:
- To compare the efficacy of segmental versus marginal resection for mandibular SCC.
- To evaluate treatment outcomes based on disease stage.
- To identify optimal surgical strategies for different stages of lower alveolar ridge SCC.
Main Methods:
- Retrospective analysis of 53 patients treated over 24 years.
- Comparison of two-year survival and no evidence of disease (NED) rates.
- Stratification of outcomes by disease stage (I-IV) and surgical modality.
Main Results:
- Marginal resection, particularly with adjuvant radiation, demonstrated comparable disease control to segmental resection in Stages I and II SCC.
- Marginal resection showed potential efficacy in Stage III disease.
- Segmental resection is recommended for Stage IV carcinomas.
Conclusions:
- Marginal resection is a viable and effective initial treatment for selected Stage I and II lower alveolar ridge SCC patients.
- Combined modality treatment (surgery plus radiation) enhances outcomes for marginal resection.
- Stage IV disease necessitates aggressive combined segmental therapy for optimal management.