Oral Squamous Cell Carcinoma of the Maxilla: On the way to patient-specific care

Abstract

This thesis studied several aspects of clinical care for MSCC patients. The aim was to ultimately improve MSCC patient-specific care. The main findings are as follows: • Both CT and CBCT are very accurate imaging methods to detect maxillary bone invasion. However, MRI is a suitable alternative if contraindications for CT are present or MRI is already made for other indications. • The best treatment of MSCC available today is probably surgery including elective neck dissection, and adjuvant (chemo)radiation in case adverse tumour characteristics are present. • Salvage surgery prolongs overall survival in case of small recurrence but might have dubious value in survival regarding larger recurrences infiltrating adjacent facial structures. • The overall 2- and 5-year mortality probability of MSCC can now be calculated with newly computed prediction models. • A wide variety of reconstructive procedures are performed, but ‘pedicled flaps’ for Brown I and the ‘fibular composite free-flap’ for Brown II-VI were favoured most among Dutch specialists.