Long-term follow up on recurrence of 305 ameloblastoma cases

Hong, Jin-Pyo; Yun, Pil‐Young; Chung, Il-Hyuk; Myoung, Hoon; Suh, Jeong-Hun; Seo, Byoung‐Moo; Lee, J.-H.; Choung, Pill‐Hoon

doi:10.1016/j.ijom.2006.11.003

Cited by 186 publications

(188 citation statements)

References 17 publications

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“…Multiple studies point to a conclusion that maxillary ameloblastomas are inherently more difficult to manage, with extensive disease at presentation, multiple recurrences, and locally aggressive behavior [2,14,15]. However, the cumulative data comparing recurrence rates of mandibular and maxillary ameloblastomas do not show significant difference between the two sites [1,9]. The current study reconciles these seemingly conflicting observations.…”

Section: Discussionsupporting

confidence: 51%

“…Multiple studies have consistently indicated that the initial surgical approach most strongly correlates with tumor recurrence [1,[9][10][11][12][13]. While curettage and enucleation with or without adjuvant Carnoy's solution and marsupialization may be acceptable therapies for some unicystic ameloblastomas, most experts currently believe that these treatment modalities have no role in management of solid/multicystic ameloblastoma [4,10].…”

Section: Discussionmentioning

confidence: 99%

“…Histopathologic study of 82 ameloblastoma resections showed that the tumor extends with a range of 2-8 mm beyond its radiographic margins [16]. Thus, many experts endorse that solid/multicystic ameloblastomas should be excised with at least 1-2 cm margin, which typically results in a segmental resection, maxillectomy or mandibulectomy [4,[9][10][11]. In a recent study of 305 patients with ameloblastoma and longterm follow-up, Hong et al [9] found that patients managed by marginal resection demonstrated significantly higher recurrence rate when compared to those who underwent segmental resection or maxillectomy (11.6 vs. 4.5 %, p = 0.004).…”

Section: Discussionmentioning

confidence: 99%

“…Recent data from several centers suggests that the initial surgical management approach and histologic growth pattern are the most important prognostic determinants in ameloblastoma [2,[9][10][11]. Radical surgery can achieve recurrence rates as low as 0-4.5 % and wider resection may be required for ameloblastomas with more aggressive histologic patterns, such as follicular, granular cell, and acanthomatous variants [9,11,12].…”

Section: Introductionmentioning

confidence: 99%

“…Radical surgery can achieve recurrence rates as low as 0-4.5 % and wider resection may be required for ameloblastomas with more aggressive histologic patterns, such as follicular, granular cell, and acanthomatous variants [9,11,12]. Despite these findings, the debate on an ideal management that would achieve cure without unnecessary compromise of cosmesis and function, is ongoing.…”

Section: Introductionmentioning

confidence: 99%

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Ameloblastoma: 25 Year Experience at a Single Institution

Milman

Ying

Pan

et al. 2016

Head and Neck Pathol

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Ameloblastoma is a rare, locally aggressive odontogenic neoplasm, accounting for fewer than 1 % of head and neck tumors. Recent literature suggests that the initial surgical approach and histologic growth patterns are the most important prognostic determinants in ameloblastoma. The aim of this study was to compare the clinical presentation, management, and outcomes of patients with ameloblastoma with data reported in the literature; the study spanned 2 decades at a single institution. The institution's database was searched for all patients with pathologically confirmed ameloblastoma, diagnosed between 1990 and 2015. The data collected included sex, age, clinical and imaging findings, management, histologic pattern, clearance of surgical margins, length of follow-up, time to recurrence, and disease-related mortality. The potential risk factors of recurrence were evaluated using log-rank test, proportional hazard model, and Fisher exact test. Review of the database yielded 54 patients with pathologically confirmed ameloblastoma and follow-up. Recurrence was noted in 13 (24 %) patients. Surgical approach was associated with the risk of recurrence (6.1 % following radical resection vs. 52 % following limited surgery, p = 0.002). There were trends toward higher recurrence rate in the group with pathologically documented positive margins (p = 0.054) and in follicular ameloblastoma (p = 0.35). Transformation into ameloblastic carcinoma was identified in two patients. There was no disease-related mortality. Our study confirms the recent data regarding the importance of radical surgical resection in management of ameloblastoma. Surgical approach appears to be the strongest predictor of tumor clearance.

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