Abstract
Seventy-nine patients with oral and oropharyngeal cancer who underwent mandibular resection from 1974 through 1997 were studied. Primary sites of disease were lower gingiva in 43 cases, floor of the mouth in 25 cases, buccal mucosa in 6 cases and oropharynx in 5 cases. Five-year cumulative survival rates were 41%, 50%, 33%, 0%, respectively. Methods of mandibular resection of these patients were as follows: segmental resection in 43, marginal resection in 24, and hemimandibulectomy or subtotal mandibulectomy in 12. Five-year cumulative survival rates were 53%, 50%, 0%, respectively. There were 25 patients who had recurrence at the primary site, but only five patients were strongly suspected of recurrence at the surgical margin of the bone. It was suggested that wider resection of soft tissue is necessary. On the other hand, marginal resection of the mandibule could be adopted to more patients because there was no recurrence in the bone after marginal resection. Since 1990, reconstruction of the mandibule has been performed using vascularized bone graft in 10 cases with segmental resection and one with marginal resection, obtaining good results. However postoperative masticatory function remained unsatisfactory, and so improvement there of is necessary.
