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Title: A retrospective cohort study on predictors associated with skull base invasion of maxillary ameloblastomas
Authors: Poramate Pitak-Arnnop
Keskanya Subbalekha
Nattapong Sirintawat
Jean Paul Meningaud
Chatpong Tangmanee
Prim Auychai
Andreas Neff
Chulalongkorn Business School
Mahidol University, Faculty of Dentistry
Chulalongkorn University
Hôpital Henri Mondor
Universitätsklinikum Gießen und Marburg, Standort Marburg
Keywords: Dentistry;Medicine
Issue Date: 1-Jan-2022
Citation: Journal of Stomatology, Oral and Maxillofacial Surgery. (2022)
Abstract: Purpose: To identify factors associated with skull base involvement (SBI) of maxillary ameloblastomas (MA). Methods: This retrospective cohort study was composed of MA patients treated during a 7-year period. Demographic, radiographic, and nine immunohistopathologic predictor variables were included. The outcome variable was presence of SBI (yes/no). Descriptive, bi- and multivariate statistics were computed, and P ≤ .05 in multivariate analyses was considered statistically significant. Results: The sample comprised 23 subjects (34.8% females; 21.7% with SBI) with a mean age of 50.3 ± 18.2 years. Candidate predictors of an SBI in MAs were 1) male gender, 2) a low Karnofsky Performance Status score (KPS), 3) multilocular radiolucency, 4) ill-defined margins, 5) cortical perforation, 6) inclusion of an unerupted tooth, 7) moderate to strong reactivity to p53, Ki-67, CD10, astrocyte elevated gene-1 (AEG-1) protein, carbonic anhydrase IX (CA IX), calretinin (calbindin2; CALB2), and BRAF-V600E, and 8) negative to low immunopositivity to α-smooth muscle actin (α-SMA) and syndecan-1 (CD138). However, multivariate analyses confirmed the significant associations of SBI with negative/low syndecan-1 reactivity (P = .003; adjusted odds ratio [ORadj.], 4.04; 95% confidence interval [95% CI], −.89 to −.48; Pearson's Correlation Coefficient [r] = −.74) and with KPS (P = .003; ORadj., 4.04; 95% CI, −.78 to −.17; r = −.54) only. Conclusions: Our findings suggest an aggressive approach to MAs with negative to low syndecan-1 immunopositivity and/or in multi-morbid patients (who may have difficulty in access to health care). Otherwise, health care inequalities due to low KPS scores should be minimized or eliminated.
ISSN: 24687855
Appears in Collections:Scopus 2022

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