In-house 3D modeling associated with margin-negative resection in mandibular oral cavity malignancies

Abstract

Objective: To evaluate whether the intraoperative use of patient specific 3D printed models is associated with better surgical margin outcomes for T4 oral cavity squamous cell carcinoma resection.

Patients and methods: A retrospective cohort study ofpatients from a single, tertiary care center diagnosed with T4 squamous cell carcinoma of the oral cavity and underwent segmental mandibulectomy between January 2021 and October 2023. Subjects were split into those who received an in-house 3D model for intraoperative use and a control group that did not receive a model or other commercial virtual planning. A retrospective chart review collected demographic information, operative characteristics, and postoperative outcomes. Statistical comparisons were made using chi square contingency tables or Mann-Whitney T test with significance set at p < 0.05.

Results: 147 patients werereviewed with 68 meeting final inclusion criteria for in-house 3D model (n = 37) and control (n = 31) groups. Cohorts were statistically similar across demographics, tumor, and operative characteristics. A statistically better margin negative rate was revealed for the in-house 3D model group compared to the control group (91.9 % versus 74.2 %, p = 0.048). No statistically significant differences were observed in post-operative treatment regimens, local recurrence, distant metastasis, or overall survival (p > 0.05) in this limited cohort.

Conclusion: The use of 3D models demonstrated increased rates of margin-negative ablation compared to conventional surgical approaches, suggesting further investigation into the utility of 3D modeling for bony tumor ablation. Heightened rates of negative margin status can impact the need for adjuvant therapies, which may potentially improve survival outcomes in larger patient populations.

Keywords: 3D printing; Mandibular malignancy; Oncologic margins; Patient-specific solutions; Point-of-care manufacturing; Squamous cell carcinoma; Virtual surgical planning.