title: Preoperative imaging and surgical margins in maxillectomy patients.
abstract: BACKGROUND
  High rates of positive surgical margins are reported after a maxillectomy. A large part of tumors that are preoperatively considered "operable" can thus not be resected with tumor-free margins.
  
  
  METHODS
  This was a retrospective study on medical files of 69 patients that underwent maxillectomy as primary treatment for a squamous cell carcinoma.
  
  
  RESULTS
  More than one third (39%) of all resections performed is incomplete, with dorsal or dorsocranial-positive surgical margins in two thirds. Correlation of tumor extension on preoperative imaging to surgical margins status revealed that dorsal and cranial tumor extension were significant prognostic factors for tumor positive surgical margins (p = .006 and p = .031, respectively). Positive margins were associated with a 2-fold increased risk of death (hazard ratio, 2.4; 95% confidence interval, 1.2-4.9).
  
  
  CONCLUSIONS
  Cranial or dorsal tumor extension on preoperative imaging was a significant risk factor for positive surgical margins after maxillectomy with significant negative influence on overall survival.
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
authors.forename: Anne Marijn
authors.initials: AM
authors.lastname: Kreeft
authors.forename: Ludwig E
authors.initials: LE
authors.lastname: Smeele
authors.forename: Coen R N
authors.initials: CR
authors.lastname: Rasch
authors.forename: Michael
authors.initials: M
authors.lastname: Hauptmann
authors.forename: Derk H F
authors.initials: DH
authors.lastname: Rietveld
authors.forename: C René
authors.initials: CR
authors.lastname: Leemans
authors.forename: Alfons J M
authors.initials: AJ
authors.lastname: Balm
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008444:Maxillary Sinus Neoplasms / Q000473:pathology* / Q000601:surgery; D009062:Mouth Neoplasms / Q000473:pathology* / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate; D014057:Tomography, X-Ray Computed