Does Different Mandibulectomy (Marginal vs Segmental) Affect the Prognosis in Patients With Oral Squamous Cell Carcinoma?

It is unclear whether different mandibular surgical methods affect the prognosis of patients with oral squamous cell carcinoma (OSCC). Accordingly, the authors retrospectively compared the prognosis of patients who underwent marginal mandibulectomy (MG) or segmental mandibulectomy (SG) for OSCC and aimed to determine the factors influencing prognosis.The authors conducted a retrospective cohort study of 82 patients with OSCC who underwent mandibulectomy at their hospital from January 2001 through January 2015. All patients had a biopsy-confirmed diagnosis of OSCC adjacent to the lower mandible. The local recurrence rate and survival rate after these 2 treatment modalities were analyzed using Kaplan-Meier survival analysis. At univariate and multivariate analyses, the Cox regression model was used to screen risk factors for recurrence, including pathologic grade, pT stage, mandibular involvement, lymph node metastasis, and method of mandibulectomy. Statistical significance was considered when P values were less than .05.Of the 82 patients, 39 underwent MG and 43 underwent SG. According to statistical analysis, age, gender, pathologic grade, tumor stage, mandibular involvement, and lymph node metastasis were similar between the 2 groups. The 3- and 5-year local recurrence rates were not significantly different between the 2 groups (P > .05). The 3- and 5-year survival rates were not significantly different between the 2 groups (P > .05). Poorly differentiated pathologic type was the only prognostic factor for OSCC at multivariate Cox regression analysis (P = .001).The results of this study suggest that MG is safe for some evaluated patients with OSCC. Of the prognostic factors studied, MG was not associated with worse prognosis; however, poorly differentiated OSCC affected the prognosis for oral carcinoma.