Sporadic versus syndromic keratocysts-Can we predict treatment outcome? A review of 102 cysts.

Abstract

Keratocystic odontogenic tumor (KCOT) demonstrates variable growth mechanisms and biologic behavior, partly due to origin and histology. We looked for the most contributing factors in predicting outcome of treatment. We retrospectively reviewed 118 medical files of patients diagnosed with KCOT (by tissue biopsy before surgical treatment) with/without nevoid basal cell carcinoma syndrome (NBCCS) from 1995 to 2015. Data were recorded and analyzed statistically to determine the treatment-outcome correlation. KCOTs in NBCCS patients were termed "syndromic" and random KCOTs termed "sporadic." Of 102 cysts, 32 were diagnosed with NBCCS. Sporadic KCOTs were significantly larger upon diagnosis (p<.017). Factors most indicative of postsurgical complications are older age (p<.011), upper jaw location, and size of lesion ≥9.5cm². Sporadic KCOTs significantly increased the chances of complications approximately threefold (p<.043). Higher recurrence rate was significant in syndromic cysts (47%) compared to sporadic cysts (20%) (p<.009). Recurrence time was 3years on average. Postsurgical complications may be expected in: older patients, upper jaw location, extensive lesions, and sporadic KCOT. Most KCOT recurrence is diagnosed 3years from treatment.