A pilot study of segmental mandibulectomy with surgical navigation using fluorine-18 fluorodeoxyglucose positron-emission tomography/computed tomography

Objectives/Hypothesis: To evaluate the efficacy of treating lower gum cancer using fluorine-18 fluorodeoxyglucose positron-emission tomography/computed tomography ([18] F-FDG PET/CT) surgical navigation to control bony margins during segmental mandibulectomy. Study Design: This study was conducted between September 2010 and June 2011 in a tertiary referral center in southern Taiwan. Methods: Segmental mandibulectomy was performed using surgical navigation via [18] F-FDG PET/CT. Bony margins after decalcification, the 1-year survival rate, and local control rate were evaluated. Results: Ten cases of advanced lower gum cancer in male patients were treated by mandibulectomy, and the bony margins required to excise all neoplastic cells were negative in all cases by using surgical navigation. The minimal distance from the tumor border to the bony incision was 2 cm (2.0-2.9 cm). The mean follow-up period was 15.2 months (range, 6-24 months) with a 1-year survival rate of 90% and local control rate of 100%. Conclusions: The segmental mandibulectomy aided by surgical navigation with [18] F-FDG PET/CT guidance is simple and feasible to ensure adequate bony margins intraoperatively, but more patients are necessary to support these findings.