Accuracy of preoperative clinical examination and imaging for mandibular resection in oral cancer: a systematic review of diagnostic test accuracy studies |
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| Affiliation: | 1. Liverpool Head and Neck Centre, Liverpool University Hospitals NHS Foundation Trust, Lower Lane, Liverpool L9 7AL, UK;2. Department of Molecular and Clinical Cancer Medicine, University of Liverpool Cancer Research Centre, 200 London Road, Liverpool L3 9TA, UK;1. Department of Oral and Maxillofacial Surgery, University of Freiburg, Faculty of Medicine, Freiburg, Germany;2. Hospital General Universitario de Albacete, Departamento de Cirugía Oral y Maxilofacial, Albacete, Spain;3. Hospital Universitario Virgen de las Nieves de Granada, Departamento de Cirugía Oral y Maxilofacial, Granada, Spain;1. Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, National University Hospital, Singapore;2. Yong Loo Lin School of Medicine, National University of Singapore, Singapore;3. Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore;1. Department of Medical Cosmetology, The First Clinical Medical College of China Three Gorges University, Yichang Central People’s Hospital, Institute of Medical Cosmetology, China Three Gorges University, Yichang 443003, China;2. College of Biological & Pharmaceutical Sciences, China Three Gorges University, Yichang 443002, China;1. Department of Oral and Maxillofacial Surgery, Tokyo Women’s Medical University, 8-1, Kawadacho, Shinjuku-ku, Tokyo 162-0054, Japan;2. Bunkyo Nagahama Orthodontic Office, 1-33-218, Hakusan, Bunkyo-ku, Tokyo 113-0001, Japan;1. Nepean Clinical School, University of Sydney, Australia;2. Northern Clinical School, University of Sydney, Australia;3. Royal Prince Alfred Institute of Academic Surgery, University of Sydney, Australia;4. Department of Surgery, Westmead Hospital, University of Sydney, Australia;5. Research in Implementation Science and eHealth, Faculty of Health Sciences, University of Sydney, Australia |
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| Abstract: | The aim of this systematic review is not only to analyse the accuracy of clinical examination and radiological preoperative assessment of mandibular invasion reported in isolation, but to highlight those reports that have combined them. A total of 1636 titles and abstracts published between 1995 – 2000 were screened following a literature search in PubMed. Keywords were “mandible” and “squamous cell carcinoma”. A total of 90 full manuscripts were reviewed with 24 meeting defined inclusion/exclusion criteria and yielding the data reported. The most sensitive test was single photon emission tomography with eight out of the 10 studies reporting sensitivity higher than 95%. Magnetic resonance imaging (MRI) demonstrated superior sensitivity but was less specific than computed tomography (CT). A single report attempted to report the combined CT and MRI scans with a separate expert reporting but did not result in more reliable detection. Periosteal stripping was not reported, and there was insufficient data to establish the value of new technologies. This review confirms that, to our knowledge, there are no reliable data on the results of combining imaging techniques with or without clinical examination. It emphasises the lack of data for the combination of preoperative techniques to enhance safe oncological resection of the mandible. Based on the evidence gathered in this review an algorithm of assessment of possible mandibular invasion is proposed. With new technologies available and 3-dimensional models to help plan the mandibular resection and reconstruction, the potential of combining preoperative investigations should be fully realised through prospective research. |
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| Keywords: | Mandible Squamous cell carcinoma Oral cancer Systematic review Imaging Histology |
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