Nomogram for predicting postoperative temporomandibular joint degeneration after mandibulectomy for oral cavity cancer: a study on patients using CT and MRI data.

Abstract

The aim of this study was to develop a model for predicting the risk of postoperative temporomandibular joint osteoarthritis (TMJOA) in patients receiving a segmental or marginal mandibulectomy for oral cavity cancer . A total of 371 patients with buccal or gingival cancer who underwent mandibulectomy were included in this retrospective cohort study. Demographic data, computed tomography, and magnetic resonance images were reviewed. Univariate and multivariate Cox regression analyses were performed to develop a nomogram to predict post-mandibulectomy TMJOA. TMJOA was identified in 81 of the 371 patients at 2 years and 107 at 4 years. The predictors of post-mandibulectomy TMJOA were segmental mandibulectomy (hazard ratio (HR) 2.51, 95% confidence interval (CI) 1.64-3.83, P < 0.001), age ≥ 62.5 years (HR 2.28, 95% CI 1.53-3.40, P < 0.001), BMI < 24.1 kg/m² (HR 2.13, 95% CI 1.45-3.13, P < 0.001), and American Joint Committee on Cancer stage IVa/IVb (HR 2.21, 95% CI 1.38-3.56, P = 0.001). The nomogram developed in this study exhibited good predictive capacity (area under the curve 0.742, 95% CI 0.679-0.804). The proposed model for predicting post-mandibulectomy TMJOA in patients with buccal or gingival cancer can identify high-risk individuals for early preventive oral rehabilitation.