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Preoperative imaging and surgical margins in maxillectomy patients
Author(s) -
Kreeft Anne Marijn,
Smeele Ludwig E.,
Rasch Coen R. N.,
Hauptmann Michael,
Rietveld Derk H. F.,
Leemans C. René,
Balm Alfons J. M.
Publication year - 2012
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.21987
Subject(s) - medicine , confidence interval , hazard ratio , dorsum , surgery , basal cell , surgical margin , retrospective cohort study , head and neck , head and neck squamous cell carcinoma , medical record , overall survival , radiology , radiation therapy , head and neck cancer , resection , anatomy
Background High rates of positive surgical margins are reported after a maxillectomy. A large part of tumors that are preoperatively considered “operable” can thus not be resected with tumor‐free margins. Methods This was a retrospective study on medical files of 69 patients that underwent maxillectomy as primary treatment for a squamous cell carcinoma. Results More than one third (39%) of all resections performed is incomplete, with dorsal or dorsocranial‐positive surgical margins in two thirds. Correlation of tumor extension on preoperative imaging to surgical margins status revealed that dorsal and cranial tumor extension were significant prognostic factors for tumor positive surgical margins ( p = .006 and p = .031, respectively). Positive margins were associated with a 2‐fold increased risk of death (hazard ratio, 2.4; 95% confidence interval, 1.2–4.9). Conclusion Cranial or dorsal tumor extension on preoperative imaging was a significant risk factor for positive surgical margins after maxillectomy with significant negative influence on overall survival. © 2012 Wiley Periodicals, Inc. Head Neck, 2012