Treatment Outcomes of Rare Retromolar Trigone Squamous Cell Carcinoma Using Combined Modalities
| Autor: | Usman Khaleeq, Arif Jamshed, Mohammad Adeel, Taskheer Abbas, Riaz Hussain, Muhammad Faisal, Abdul Wahid Anwer |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
squamous cell carcinoma
medicine.medical_specialty medicine.diagnostic_test business.industry medicine.medical_treatment Retromolar Trigone General Engineering oral cavity tumors Induction chemotherapy Physical examination Segmental Mandibulectomy 030218 nuclear medicine & medical imaging Radiation therapy retromolar trigone 03 medical and health sciences 0302 clinical medicine Mandibulectomy Retromolar Trigone Squamous Cell Carcinoma Oncology 030220 oncology & carcinogenesis medicine Radiology business Chemoradiotherapy |
| Zdroj: | Cureus |
| ISSN: | 2168-8184 |
| Popis: | Background Retromolar trigone squamous cell carcinoma is relatively uncommon and due to its complex anatomy has always remained a challenge in terms of loco-regional control and survival. Surgery, radiotherapy, and chemotherapy as combined modalities have been used but high recurrence rates result in poor outcome. Methods We have retrospectively evaluated records of 62 patients treated in Head and Neck Oncology unit of Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH and RC), Lahore, Pakistan from 2004 to 2014 who were included based on the criteria of histopathological proven squamous cell carcinoma of retromolar trigone (RMT) treated with radical intent. Diagnostic workup for all patients involved clinical examination, imaging modalities usually magnetic resonance imaging (MRI), computerized tomography (CT), Orthopantomogram (OPG), and chest x-ray (CXR) to evaluate regional and distant metastasis, respectively. Kaplan-Meier survival curves were used to depict survival. Results The study was comprised of 36 male and 26 female patients. Treatment modalities used are surgery only (n = 1), radiotherapy alone (n = 13), radiotherapy followed by surgery (n = 10), chemoradiotherapy (n = 16), induction chemotherapy followed by concurrent chemoradiotherapy (n = 19), induction chemotherapy followed by surgery, and radiotherapy (n = 2). Surgical interventions include wide local excisions (n = 6), marginal mandibulectomy (n = 4), and segmental mandibulectomy (n = 4). Surgical margins were clear in 54%, close in 38%, and involved in 8% of patients. AJCC 7th edition showed cT1 8%, cT2 22%, cT3 14%, and cT4 56% while pT1 2%, pT2 3%, and pT4 8%. During follow-up, 18% patients have come up with local recurrence, 22% showed persistent disease while 9% have presented with distant metastasis. The five-year and overall survivals are 38% and 22%, respectively. Conclusion Retromolar trigone involvement poses many vital structures at risk of involvement. Late presentation results in involvement of masticator space compromising both mouth opening and surgical outcomes. Surgery and radiotherapy have shown comparable results in disease control. Bone invasion has shown poor outcome in terms of loco-regional control and overall survival. |
| Databáze: | OpenAIRE |
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