Preoperative imaging and surgical margins in maxillectomy patients
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 maxillect...
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| Veröffentlicht in: | Head & neck 2012-11, Vol.34 (11), p.1652-1656 |
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| creator | Kreeft, Anne Marijn Smeele, Ludwig E. Rasch, Coen R. N. Hauptmann, Michael Rietveld, Derk H. F. Leemans, C. René Balm, Alfons J. M. |
| description | 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 |
| doi_str_mv | 10.1002/hed.21987 |
| format | Article |
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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</description><identifier>ISSN: 1043-3074</identifier><identifier>EISSN: 1097-0347</identifier><identifier>DOI: 10.1002/hed.21987</identifier><identifier>PMID: 22252962</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Biological and medical sciences ; Carcinoma, Squamous Cell - pathology ; Carcinoma, Squamous Cell - surgery ; Facial bones, jaws, teeth, parodontium: diseases, semeiology ; Female ; Head and Neck Neoplasms - pathology ; Head and Neck Neoplasms - surgery ; Humans ; imaging ; Magnetic Resonance Imaging ; Male ; maxillary sinus cancer ; Maxillary Sinus Neoplasms - pathology ; Maxillary Sinus Neoplasms - surgery ; maxillectomy ; Medical sciences ; Mouth Neoplasms - pathology ; Mouth Neoplasms - surgery ; Neoplasm Recurrence, Local - pathology ; oral cancer ; Otorhinolaryngology. Stomatology ; Retrospective Studies ; Squamous Cell Carcinoma of Head and Neck ; surgery ; surgical margins ; survival ; Survival Rate ; Tomography, X-Ray Computed ; Tumors ; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology</subject><ispartof>Head & neck, 2012-11, Vol.34 (11), p.1652-1656</ispartof><rights>Copyright © 2012 Wiley Periodicals, Inc.</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4597-637e95ce64670e091943122298ca8401750a9148dc33f811b4ec244e55cde49e3</citedby><cites>FETCH-LOGICAL-c4597-637e95ce64670e091943122298ca8401750a9148dc33f811b4ec244e55cde49e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fhed.21987$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fhed.21987$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26575953$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22252962$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kreeft, Anne Marijn</creatorcontrib><creatorcontrib>Smeele, Ludwig E.</creatorcontrib><creatorcontrib>Rasch, Coen R. N.</creatorcontrib><creatorcontrib>Hauptmann, Michael</creatorcontrib><creatorcontrib>Rietveld, Derk H. F.</creatorcontrib><creatorcontrib>Leemans, C. René</creatorcontrib><creatorcontrib>Balm, Alfons J. M.</creatorcontrib><title>Preoperative imaging and surgical margins in maxillectomy patients</title><title>Head & neck</title><addtitle>Head Neck</addtitle><description>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</description><subject>Biological and medical sciences</subject><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Carcinoma, Squamous Cell - surgery</subject><subject>Facial bones, jaws, teeth, parodontium: diseases, semeiology</subject><subject>Female</subject><subject>Head and Neck Neoplasms - pathology</subject><subject>Head and Neck Neoplasms - surgery</subject><subject>Humans</subject><subject>imaging</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>maxillary sinus cancer</subject><subject>Maxillary Sinus Neoplasms - pathology</subject><subject>Maxillary Sinus Neoplasms - surgery</subject><subject>maxillectomy</subject><subject>Medical sciences</subject><subject>Mouth Neoplasms - pathology</subject><subject>Mouth Neoplasms - surgery</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>oral cancer</subject><subject>Otorhinolaryngology. Stomatology</subject><subject>Retrospective Studies</subject><subject>Squamous Cell Carcinoma of Head and Neck</subject><subject>surgery</subject><subject>surgical margins</subject><subject>survival</subject><subject>Survival Rate</subject><subject>Tomography, X-Ray Computed</subject><subject>Tumors</subject><subject>Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology</subject><issn>1043-3074</issn><issn>1097-0347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kDlPAzEQhS0EgnAU_AG0DRIUCz7X6xJCWEARUHCUlnEmwbBHsDeQ_HsckkBF5Sfre_NmHkL7BJ8QjOnpKwxOKFG5XEMdgpVMMeNyfa45SxmWfAtth_CGMWYZp5toi1IqqMpoB53fe2jG4E3rPiFxlRm5epSYepCEiR85a8qkMlHUIXF1lFNXlmDbppol4-iBug27aGNoygB7y3cHPV72HrpXaf-uuO6e9VPLRdwpYxKUsJDxTGLAiijOSFxE5dbkHBMpsFGE5wPL2DAn5IWDpZyDEHYAXAHbQUeLuWPffEwgtLpywUJZmhqaSdCEEJ4pKSmL6PECtb4JwcNQj328zc80wXpemY6V6Z_KInuwHDt5qeLvilx1FIHDJWBC7GPoTW1d-OMyIYUS89DTBfflSpj9n6iveher6HThcKGF6a_D-HedSSaFfr4t9E3ByLMqCv3EvgFPRo_q</recordid><startdate>201211</startdate><enddate>201211</enddate><creator>Kreeft, Anne Marijn</creator><creator>Smeele, Ludwig E.</creator><creator>Rasch, Coen R. N.</creator><creator>Hauptmann, Michael</creator><creator>Rietveld, Derk H. F.</creator><creator>Leemans, C. René</creator><creator>Balm, Alfons J. M.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201211</creationdate><title>Preoperative imaging and surgical margins in maxillectomy patients</title><author>Kreeft, Anne Marijn ; Smeele, Ludwig E. ; Rasch, Coen R. N. ; Hauptmann, Michael ; Rietveld, Derk H. F. ; Leemans, C. René ; Balm, Alfons J. M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4597-637e95ce64670e091943122298ca8401750a9148dc33f811b4ec244e55cde49e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Biological and medical sciences</topic><topic>Carcinoma, Squamous Cell - pathology</topic><topic>Carcinoma, Squamous Cell - surgery</topic><topic>Facial bones, jaws, teeth, parodontium: diseases, semeiology</topic><topic>Female</topic><topic>Head and Neck Neoplasms - pathology</topic><topic>Head and Neck Neoplasms - surgery</topic><topic>Humans</topic><topic>imaging</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>maxillary sinus cancer</topic><topic>Maxillary Sinus Neoplasms - pathology</topic><topic>Maxillary Sinus Neoplasms - surgery</topic><topic>maxillectomy</topic><topic>Medical sciences</topic><topic>Mouth Neoplasms - pathology</topic><topic>Mouth Neoplasms - surgery</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>oral cancer</topic><topic>Otorhinolaryngology. Stomatology</topic><topic>Retrospective Studies</topic><topic>Squamous Cell Carcinoma of Head and Neck</topic><topic>surgery</topic><topic>surgical margins</topic><topic>survival</topic><topic>Survival Rate</topic><topic>Tomography, X-Ray Computed</topic><topic>Tumors</topic><topic>Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kreeft, Anne Marijn</creatorcontrib><creatorcontrib>Smeele, Ludwig E.</creatorcontrib><creatorcontrib>Rasch, Coen R. N.</creatorcontrib><creatorcontrib>Hauptmann, Michael</creatorcontrib><creatorcontrib>Rietveld, Derk H. F.</creatorcontrib><creatorcontrib>Leemans, C. René</creatorcontrib><creatorcontrib>Balm, Alfons J. M.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Head & neck</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kreeft, Anne Marijn</au><au>Smeele, Ludwig E.</au><au>Rasch, Coen R. N.</au><au>Hauptmann, Michael</au><au>Rietveld, Derk H. F.</au><au>Leemans, C. René</au><au>Balm, Alfons J. M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preoperative imaging and surgical margins in maxillectomy patients</atitle><jtitle>Head & neck</jtitle><addtitle>Head Neck</addtitle><date>2012-11</date><risdate>2012</risdate><volume>34</volume><issue>11</issue><spage>1652</spage><epage>1656</epage><pages>1652-1656</pages><issn>1043-3074</issn><eissn>1097-0347</eissn><abstract>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</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>22252962</pmid><doi>10.1002/hed.21987</doi><tpages>5</tpages></addata></record> |
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| subjects | Biological and medical sciences Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - surgery Facial bones, jaws, teeth, parodontium: diseases, semeiology Female Head and Neck Neoplasms - pathology Head and Neck Neoplasms - surgery Humans imaging Magnetic Resonance Imaging Male maxillary sinus cancer Maxillary Sinus Neoplasms - pathology Maxillary Sinus Neoplasms - surgery maxillectomy Medical sciences Mouth Neoplasms - pathology Mouth Neoplasms - surgery Neoplasm Recurrence, Local - pathology oral cancer Otorhinolaryngology. Stomatology Retrospective Studies Squamous Cell Carcinoma of Head and Neck surgery surgical margins survival Survival Rate Tomography, X-Ray Computed Tumors Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology |
| title | Preoperative imaging and surgical margins in maxillectomy patients |
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