PROGNOSTIC IMPACT OF MARGINAL MANDIBULECTOMY IN THE PRESENCE OF SUPERFICIAL BONE INVASION AND THE NONONCOLOGIC OUTCOME

Background. Treatment of oral cavity cancer may require variable extent of mandibular resection. Marginal mandibulectomy is a controversial technique in providing oncologic resection margin. This study analyzes the efficacy of local oncologic control and the morbidity of marginal mandibulectomy in oral cavity carcinoma. Nononcologic complication of osteoradionecrosis is discussed. Methods. A retrospective cohort study analyzed clinicopathologic features of 43 patients with oral cavity cancer who underwent marginal mandibulectomy. Histologic mandibular invasion was examined as a function of local control and contribution to osteoradionecrosis. Results. Bone invasion was present in 16.3% of patients with marginal mandibulectomy. Local control rates were 85.7% in the bone invasion group and 77.8% in the no bone invasion group (p = .7). Osteoradionecrosis rates were 16.7% and 17.6%, respectively (p = .96). There was no significant difference between the 2 groups. Conclusions. Marginal mandibulectomy is oncologically sound in providing a safe resection margin in oral cavity cancer abutting or superficially invading the mandible. (C) 2010 Wiley Periodicals, Inc. Head Neck 33: 708-713, 2011