Analysis of recurrence factors after radical mandibular resection for ameloblastoma

Lei Chen; Xu-Hui Zhang; Ping Zhou; Yi-Fang Zhao; Yan-Ping Hu; Jun Jia; Zi-Li Yu

doi:10.1016/j.jormas.2024.102190

Analysis of recurrence factors after radical mandibular resection for ameloblastoma

J Stomatol Oral Maxillofac Surg. 2024 Dec 5:102190. doi: 10.1016/j.jormas.2024.102190. Online ahead of print.

Authors

Lei Chen¹, Xu-Hui Zhang², Ping Zhou³, Yi-Fang Zhao⁴, Yan-Ping Hu², Jun Jia⁵, Zi-Li Yu⁶

Affiliations

¹ State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 430079, Wuhan, PR China.
² Department of Oral Surgery, Stomatological Hospital of Xiamen Medical College, 361000, Xiamen, PR China.
³ Oral Radiology Department, School and Hospital of Stomatology, Wuhan University, 430079, Wuhan, PR China.
⁴ State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 430079, Wuhan, PR China; Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, 430079, Wuhan, PR China.
⁵ State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 430079, Wuhan, PR China; Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, 430079, Wuhan, PR China. Electronic address: junjia@whu.edu.cn.
⁶ State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 430079, Wuhan, PR China; Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, 430079, Wuhan, PR China. Electronic address: zili09@whu.edu.cn.

PMID: 39644972
DOI: 10.1016/j.jormas.2024.102190

Abstract

Background: To analyze causes of recurrence following radical mandibular resection of ameloblastoma, and to propose surgical variation.

Methods: We conducted a retrospective analysis of patients treated for ameloblastoma from 2012 to 2024, specifically those who underwent radical mandibular resection followed by reconstruction with autologous bone flaps, focusing on cases of recurrence.

Results: Six patients were included in the study, all with primary tumors located in the mandible. Recurrence occurred 5 to 23 years post-surgery. Two patients had recurrence within the residual mandible due to insufficient margins, necessitating further resection and reconstructed with bone flaps Three patients had recurrences associated with residual tumor cells in the soft tissue, which affected the grafted bone: two required extensive resection and additional bone flap reconstruction, while one had a limited recurrence that was managed by soft tissue excision. Additionally, one patient had an isolated soft tissue recurrence that was addressed through resection.

Conclusion: Adequate resection margins are vital to minimizing recurrence risk. Invasive procedures should be avoided to prevent tumor spread, and thorough excision of affected areas during surgery is essential.

Keywords: Ameloblastoma; Autologous bone flap reconstruction; Radical mandibular resection; Recurrence; Recurrence factors.