Sporadic versus syndromic keratocysts - Can we predict treatment outcome? A review of 102 cysts

Abstract

Objectives

Keratocystic odontogenic tumor (KCOT) demonstrates variable growth mechanisms and biologic behavior, partly due to origin and histology. We looked for the most contributing factors in predicting outcome of treatment.

Subjects and Methods

We retrospectively reviewed 118 medical files of patients diagnosed with KCOT (by tissue biopsy before surgical treatment) with/without nevoid basal cell carcinoma syndrome (NBCCS) from 1995 to 2015. Data were recorded and analyzed statistically to determine the treatment-outcome correlation. KCOTs in NBCCS patients were termed "syndromic" and random KCOTs termed "sporadic".

Results

Of 102 cysts, 32 were diagnosed with NBCCS. Sporadic KCOTs were significantly larger upon diagnosis (p<0.017). Factors most indicative of post-surgical complications are older age (p<0.011), upper jaw location, and size of lesion ≥9.5 cm². Sporadic KCOTs significantly increased the chances of complications approximately 3 fold (p<0.043). Higher recurrence rate was significant in syndromic cysts (47%) compared to sporadic cysts (20%) (p<0.009). Recurrence time was 3 years on average.

Conclusions

Post-surgical complications may be expected in: older patients, upper jaw location, extensive lesions and sporadic KCOT. Most KCOT recurrence is diagnosed 3 years from treatment.

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