Recurrence of orofacial tumours and tumour-like lesions after ablative surgery: A 15-year retrospective review of 27 cases
Background: With recurrence of orofacial tumours and tumour-like lesions after surgical treatment, there is increased facial deformity, and the accompanying secondary surgery leads to further facial mutilation and impaired patients’ well-being. Objective: To determine the recurrent orofacial lesions after their surgical ablation, in addition to the demographics of patients, histopathological diagnosis, site of the lesion, duration between initial surgery and recurrence, and the corrective surgery.
Methods: A retrospective analysis of the medical records and histopathological reports of patients, who presented in the Oral and Maxillofacial Unit of the institution over 15 years, was undertaken. Information on demographics, histopathological diagnosis, site of the lesion, duration between initial surgery and recurrence, and the corrective surgery were obtained.
Results: During this period, 368 patients that were treated had complete clinical data, while 27/368 (7.3%) presented with recurrent lesions. They were aged 6 to 59 years, with male-to-female distribution ratio of 1:1.3 (P= 0.3). The benign lesions accounted for 24 (88.9%, P=0.000) cases, while odontogenic tumours recurred (P=0.001) more than the other types of lesion. The lesions were seen more often in the mandible (P= 0.001), and the frequency of patients was highest in the 21-30 years age group (P= 0.02). Most of the recurrent cases were seen within 2 years after the initial surgery (85.2%, P= 0.001). Majority of the corrective surgeries were segmental mandibular resection (37.1%), hemi-mandibulectomy (25.9%) and hemi-maxillectomy (18.5%).
Conclusions: This study showed that 7.3% of the lesions recurred after initial ablative surgery. Benign lesions particularly ameloblastoma and fibromyxoma which are locally invasive constitute the majority of the cases that relapsed. A future prospective study will address the limitations of this study.