Mandibular bone invasion in oral squamous cell carcinoma: diagnostic concordance between radiology and histopathology

Prathamesh S. Karande; Aditi Saha; Ashwini Mane; Navnath Dhone; Parag Watve; Chaitanya Patil; Prathamesh Pawar

doi:10.18203/issn.2454-5929.ijohns20261498

Authors

Prathamesh S. Karande Department of Head and Neck Oncology, Kolhapur Cancer Centre, Kolhapur, Maharashtra, India
Aditi Saha Department of Head and Neck Oncology, Kolhapur Cancer Centre, Kolhapur, Maharashtra, India
Ashwini Mane Department of Head and Neck Oncology, Kolhapur Cancer Centre, Kolhapur, Maharashtra, India
Navnath Dhone Department of Radiology, Kolhapur Cancer Centre, Kolhapur, Maharashtra, India
Parag Watve Department of Head and Neck Oncology, Kolhapur Cancer Centre, Kolhapur, Maharashtra, India
Chaitanya Patil Department of Pain and Palliative Oncology, Kolhapur Cancer Centre, Kolhapur, Maharashtra, India
Prathamesh Pawar Department of Oncopathology, Kolhapur Cancer Centre, Kolhapur, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20261498

Keywords:

Radiological bone assessment, Oral squamous cell carcinoma, Adjuvant therapy, Loco-regional recurrence, Pathological bone invasion

Abstract

Background: Oral squamous cell carcinoma (OSCC), constituting 90% of oral cancers, frequently invades the mandible, complicating staging, prognosis, and surgical planning. Contrast-enhanced CT (CECT) is vital for detecting bone invasion and guiding management.

Methods: A retrospective study was conducted on patients diagnosed with OSCC who showed radiological evidence of bone involvement and subsequently underwent surgical intervention between January 2020 and December 2023. Parameters assessed included patient demographics, surgical approach, radiological and histopathological bone involvement, tumor and nodal staging, recurrence patterns, distant metastasis, and adjuvant therapy received.

Results: The study included 74 patients, with a male predominance (65 males, 87.83%; 9 females, 12.16%). The mean age was 54.66±0.49 years, and the median follow-up period was 6 months. In 66 out of 74 patients (89.28%), radiological findings were consistent with histopathological confirmation, supporting the diagnostic reliability of contrast-enhanced computed tomography (CECT). Among the 55 patients who received radiotherapy, local recurrence occurred in 16.4%, while regional and loco-regional recurrences were comparatively lower.

Conclusions: This study highlights a strong agreement between radiological and pathological evaluations in identifying bone involvement in oral carcinoma, affirming the utility of CECT as an effective, non-invasive diagnostic tool.

References

Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral Oncol. 2009;45(5):309-16.

Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17-48.

Pindborg JJ, Reichart PA, Smith CJ, Van der Waal I. Histopathological subtypes of oral squamous cell carcinoma: prognostic relevance. J Cancer Res Ther. 2011;7(4):446-50.

Kowalski LP, Bagietto R, Lara JR, Santos RL, Silva JF, Magrin J. Histologic assessment of bone invasion in oral squamous cell carcinoma. Am J Surg Pathol. 2010;34(5):645-53.

Jones J, Franklin CD, Lamey PJ. Clinical and radiographic evaluation of mandibular invasion in patients with oral squamous cell carcinoma. J Can Dent Assoc. 2007;73(6):525-9.

Chaturvedi A, Puri M, Bansal S, Gupta S, Singh R. Role of imaging in evaluation of mandibular invasion in oral cancers. Indian J Radiol Imaging. 2018;28(2):167-73.

Kumar EW, Bhatia M, Reddy G, Singh R, Wadhwa E. Role of CT and MRI in preoperative assessment of mandibular invasion by oral squamous cell carcinoma: a systematic review. Head Neck. 2020;42(3):613-22.

Chen CH, Su WY, Yang SC, Chen YL, Lin YC. Correlation between preoperative computed tomography imaging and histopathological evaluation of mandibular invasion in oral cancer. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;118(2):215-21.

Scully C, Newman L. Surgical treatment of oral cancer: a review of current practices. Aust Dent J. 2005;50(4):241-5.

Brown JS, Lowe D, Kalavrezos N, Steele J, Magennis P, Rogers SN. Patterns of invasion and routes of tumor entry into the mandible by oral squamous cell carcinoma. Head Neck. 2002;24(4):370-83.

Tsai CJ, Hofstede TM, Sturgis EM, Garden AS, Lindberg ME, Wei Q, et al. Adjuvant radiotherapy improves outcomes in early-stage oral cavity cancer. Int J Radiat Oncol Biol Phys. 2015;91(1):132-9.

Faraji F, Eisele DW, Fakhry C. Impact of radiotherapy delay on outcomes in head and neck cancer. Cancer. 2019;125(8):1321-9.

Lee YG, Kim HJ, Lee JH, Kim SH, Kim JY, Jeong Y, et al. Recurrence in head and neck cancer patients without adjuvant therapy. Oral Oncol. 2020;104:104618.

Trosman SJ, Koyfman SA, Ward MC, Deschler DG, Michel L, Adelstein DJ. Patterns and timing of recurrence in head and neck cancer. Laryngoscope. 2020;130(1):170-6.

Ibrahim T, El-Galaly TC, Hutchings M, Mikhaeel NG, De Nully Brown P, Møller MB, et al. Comparison of PET/CT and bone marrow biopsy in lymphoma staging. Eur J Nucl Med Mol Imaging. 2015;42(11):1834-41.

Zamagni E, Tacchetti P, Cavo M. Role of imaging in evaluating bone marrow involvement in multiple myeloma. Blood Rev. 2019;33(2):183-90.