How well do we manage the odontogenic keratocyst? A multicenter study

Publication date: Available online 14 December 2018

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Author(s): Brian Kinard, Gentry Hansen, Marshall Newman, Peter Dennis, Tyler Haeffs, Sebastian Perez, Hamao Sakamoto, Martin Steed, Pamela Hughes, Meredith August, Shelly Abramowicz

Abstract

Objective

To answer the clinical question: among patients treated for odontogenic keratocysts (OKCs), what is the overall 5-year disease-free rate and what factors are associated with disease recurrence?

Study Design

The investigators implemented a multicenter retrospective cohort study composed of patients presenting for the evaluation and management of previously untreated OKCs. The predictor variables were grouped into demographic, medical, radiographic and operative categories. The primary outcome variable was time to lesion recurrence. Data analyses were performed using bivariate analysis and univariate or multivariate Cox proportional hazards models.

Results

The study sample was composed of 231 OKCs. Fifty-seven (24.7%) were treated with decompression with residual cystectomy, 86 (37.2%) with enucleation without adjuvant therapy and 78 (33.8%) with enucleation with peripheral ostectomy. There were 44 recurrences (19%), with a median time to recurrence of 26.7 months [15.8, 49.8].

Conclusion

This multicenter study is the largest study analyzing disease recurrence after treatment of OKCs using appropriate statistical analysis for a time-to-event outcome (disease recurrence). The 5-year disease-free estimate was 29%. Mandibular lesions, multilocular lesions and lesions treated with decompression and residual cystectomy were associated with recurrence.

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