Recurrence and cancerization of ameloblastoma: multivariate analysis of 87 recurrent craniofacial ameloblastoma to assess risk factors associated with early recurrence and secondary ameloblastic carcinoma.
Recurrence and cancerization of ameloblastoma: multivariate analysis of 87 recurrent craniofacial ameloblastoma to assess risk factors associated with early recurrence and secondary ameloblastic carcinoma.
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成釉细胞瘤的复发和癌化：对 87 例复发性颅面成釉细胞瘤进行多变量分析，以评估与早期复发和继发性成釉细胞癌相关的危险因素
DOI：
10.21147/j.issn.1000-9604.2017.03.04
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发表时间：
2017-06
期刊：
影响因子：
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通讯作者：
Cao W
中科院分区：
文献类型：
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作者：
Yang R;Liu Z;Gokavarapu S;Peng C;Ji T;Cao W
目的 成釉细胞瘤的复发和进展是不可预测的。因此，我们研究了临床因素对复发时间的影响，并分析了与早期复发和癌化相关的临床因素。然后我们开发了一个分期系统来预测早期复发和癌化。方法记录上海交通大学医学院附属第九人民医院收治的所有原发性颅面成釉细胞瘤患者。有 87 个复发病例用于创建分期系统，并通过 Cox 回归分析测试与手术后早期复发或癌化相关的危险因素。结果 颅面部成釉细胞瘤患者890例，复发72例。还有15例癌症复发。总体复发率为9.78%，癌变率为1.69%。原发病例根据临床病理特征分为以下3期：I期，肿瘤最大直径≤6cm； II期，肿瘤最大直径>6cm或肿瘤侵犯上颌窦/眶底/软组织； III期，肿瘤侵犯颅底或转移至区域淋巴结。当手术方式采用偏相关控制时，分期与复发时间有显着性差异（P=0.004）。 Cox分析显示肿瘤分期与复发时间（P=0.027）和癌化时间（P=0.002）相关。然而，当调整共同变量时，手术方法并不影响复发时间。结论肿瘤大于6 cm且侵犯软组织或邻近解剖结构与早期复发相关。该分期系统可用于预测成釉细胞瘤患者早期复发和癌变的危险因素。
Objective The recurrence and progression of ameloblastoma are unpredictable. Therefore, we examined the influence of clinical factors on recurrence time and analyzed the clinical factors associated with early recurrence and cancerization. We then developed a staging system to predict early recurrence and cancerization. Methods All of the primary craniofacial ameloblastoma patients treated in Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine were recorded. There were 87 recurrent cases used to create a staging system and tested in a Cox regression analysis for risk factors associated with early recurrence or cancerization following surgery. Results There were 890 craniofacial ameloblastoma patients, and 72 cases had recurrence. There were also 15 cases with cancerous recurrence. The overall recurrence rate was 9.78%, and the cancer rate was 1.69%. The primary cases were classified into the following 3 stages based on clinicopathological features: stage I, the maximum tumor diameter ≤6 cm; stage II, the maximum diameter of tumor >6 cm or tumor invasion to the maxilla sinus/orbital floor/soft tissue; and stage III, tumor invasion of the skull base or metastasis into regional lymph nodes. When the method of surgery was controlled by partial correlation, the staging had significance with recurrence time (P=0.004). The Cox analysis showed the tumor stage was correlated with recurrence time (P=0.027) and cancerization time (P=0.002). However, the surgical method did not influence the recurrence time when adjusted for cofounding variables. Conclusions Tumor larger than 6 cm and invasion to soft tissues or adjacent anatomical structures are associated with early recurrence. This staging system can be used to predict the risk factors of early recurrence and cancerization in ameloblastoma patients.