Method of mandibular resection for carcinoma of the lower gingiva. Indication and the result of marginal mandibulectomy following preoperative treatment.:INDICATION AND THE RESULT OF MARGINAL MANDIBULECTOMY FOLLOWING PREOPERATIVE TREATMENT

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Correlation among the method of mandibular resection, effect of preoperative treatment and local recurrence was investigated in 81 patients with squamous cell carcinoma of the lower gingiva who were treated in our department during the past 24 years and indication of the marginal mandibulectomy was duscussed. Complete response rate of the preoperative treatment was 55.4% and 12 out of 36 cases with complete responce were treated without surgery. Methods of mandibular resection performed in other 69 cases were as follows: segmental resection in 17, marginal resection in 43, shaving of bone and gingivectomy in 9. Local recurrence was recognized in 19 cases (23.5%). Recurrence rate of each resection method was 11.8% in segmental resection, 18.6% in marginal resection, 55.6% in shaving of bone and gingivectomy, 33.3% in no surgery respectively. Based on the positive correlation between radiographic findings of bone defect and local recurrence in cases treated with marginal resection, it was suggested that marginal mandibulectomy could be indicated to carcinoma of the lower gingiva with no bone defect or an erosive bone defect which does not extend beyond the inferior alveolar canal. Preoperative treatment was considered to be useful in the secure control of the carcinoma of the lower gingiva with the marginal mandibulectomy.
日本頭頸部癌学会の論文