Ameloblastoma of the jaws in adult: A retrospective review of local recurrent lesions based on the resection margin in the adjacent apparent healthy tissues

成人颌骨成釉细胞瘤:基于邻近表观健康组织切缘的局部复发病变回顾性分析

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Abstract

BACKGROUND: The surgical treatment of ameloblastoma of the jaws remains contentious due to the variable recurrence rate amongst its variants, the tumor's local invasive behavior, and the lack of consensus among surgeons concerning the extent of resection in the contiguous healthy tissues. OBJECTIVE: To determine the recurrence rate of ameloblastoma and its association with the resection margins. MATERIALS AND METHODS: This is a retrospective cohort study of the medical records of patients who underwent surgical resection of the jaws as the primary modality of treatment for ameloblastoma. Clinical data over the 26 years were analyzed for age, gender, site of the lesion, size, radiographic appearance, histopathological sub-type, and the incidence of recurrence post-treatment. Descriptive and bivariate statistics were computed. RESULTS: A retrospective audit of 234 cases was included in the study that was typical (solid/multicystic) ameloblastoma. The age of patients ranged from 20 to 66 years with a mean age of 33.4 ± 9.6 years, and a male-to-female ratio of 1.2: 1 (P = 0.52). The follicular and plexiform types accounted for the majority of histopathological variants (89.8%; P = 0.000). Overall, 6.8% of cases relapsed after the initial primary surgery. The rate of recurrence was high with a resection margin of 1.0 or 1.5 cm than 2.0 cm (P = 0.001). No case of recurrence was seen with a resection margin of 2.5 cm margin. CONCLUSION: A low recurrence rate of 6.8% was noted in our series of cases. A wide 2.5 cm resection margin is recommended in the adjacent healthy tissues.

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