Premium
Predictors of carcinomatous invasion of the mandible
Author(s) -
Tsue Terance T.,
McCulloch Timothy M.,
Girod Douglas A.,
Couper David J.,
Weymuller Ernest A.,
Glenn Michael G.
Publication year - 1994
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.2880160204
Subject(s) - predictive value , medicine , head and neck , basal cell , multivariate analysis , head and neck cancer , head and neck squamous cell carcinoma , radiology , predictive value of tests , reconstructive surgery , surgery , pathology , radiation therapy
Abstract The preoperative assessment of mandibular invasion by oral or oropharyngeal squamous cell carcinoma poses a challenge for the head and neck surgeon. A study of 64 composite resection patients was performed to determine which variables in the patient's history, physical exam, and diagnostic workup had a predictive association with carcinomatous mandibular invasion. Four postoperative variables were included in this analysis. Thirty‐nine percent of the mandibular specimens demonstrated cancerous involvement. A multivariate recursive partitioning statistical analysis was performed to create a decision tree. Branching was based on the two statistically predictive variables: computed tomographic (CT) scan results and primary tumor location. The guide provides improved predictive accuracy with a 100% negative predictive value (NPV) and a 46% positive predictive value (PPV). This decision guide should help the surgeon provide accurate patient counseling, anticipate reconstructive needs, and maximize surgical oncologic effectiveness. © 1994 John Wiley & Sons, Inc.