{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T04:57:33Z","timestamp":1768625853941,"version":"3.49.0"},"reference-count":44,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Mandibular bone invasion is a common and clinically relevant feature of OSCC, particularly in tumors of the lower alveolus, floor of mouth, and retromolar trigone. The prognostic value of the pattern of invasion\u2014rather than its mere presence\u2014remains insufficiently defined. Therefore, we evaluated the prognostic relevance of erosive vs. infiltrative mandibular invasion and the diagnostic reliability of preoperative CT. Methods: This retrospective, single-center observational cohort study included 83 patients with OSCC involving or adjacent to the mandible who underwent surgical resection at the Department of Oral and Maxillofacial Surgery, University Hospital Olomouc (2008\u20132018). Bone invasion type was classified histopathologically as erosive or infiltrative. Survival outcomes were analyzed using Kaplan\u2013Meier and Cox regression methods. Correlation between radiologic and histologic findings was assessed using Cohen\u2019s kappa statistics. Results: Mandibular invasion was confirmed in 50.6% of cases, of which roughly two-thirds were infiltrative. DSS differed across invasion groups (log-rank p = 0.012): infiltrative had a median DSS of 14.5 months (95% CI 0.0\u201332.8), no invasion had 54.2 months (CI not estimable), while erosive did not reach the median (fewer than half experienced the event). In the adjusted model (covariates: invasion type, ENE, grade, margins), infiltrative vs. no invasion was associated with worse DSS (aHR 1.93, 95% CI 1.02\u20133.64; p = 0.042); for OS, erosive vs. no invasion showed a protective association (aHR 0.39, 95% CI 0.16\u20130.96; p = 0.041). Positive\/close margins were independently adverse across endpoints (e.g., DSS aHR 3.30, 95% CI 1.74\u20136.22). CT\u2013histology agreement for bone invasion was \u03ba = 0.45, indicating moderate agreement. Conclusions: In this retrospective single-center cohort, the pattern of mandibular bone invasion was associated with survival: infiltrative invasion aligned with worse outcomes, whereas erosive behaved similarly to no invasion, particularly for OS. Prospective, multicenter validation is warranted before routine incorporation into risk stratification or treatment selection.<\/jats:p>","DOI":"10.3390\/diagnostics15232989","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T08:50:20Z","timestamp":1764060620000},"page":"2989","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pattern of Mandibular Bone Invasion as a Prognostic Factor"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6361-4649","authenticated-orcid":false,"given":"Richard","family":"Pink","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacky University Olomouc, 77900 Olomouc, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3454-5880","authenticated-orcid":false,"given":"Jaroslav","family":"Mich\u00e1lek","sequence":"additional","affiliation":[{"name":"Department of Clinical and Molecular Pathology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacky University Olomouc, 77900 Olomouc, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zden\u011bk","family":"Dvo\u0159\u00e1k","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacky University Olomouc, 77900 Olomouc, Czech Republic"},{"name":"Department of Plastic and Aesthetic Surgery, St. Anne\u2019s University Hospital, Faculty of Medicine, Masaryk University, Berkova 34, 61200 Brno, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Tvrd\u00fd","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacky University Olomouc, 77900 Olomouc, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lenka","family":"\u0160a\u0161kov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacky University Olomouc, 77900 Olomouc, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michal","family":"Herman","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacky University Olomouc, 77900 Olomouc, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petr","family":"Heinz","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacky University Olomouc, 77900 Olomouc, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3889-0905","authenticated-orcid":false,"given":"Mark\u00e9ta","family":"Hermanov\u00e1","sequence":"additional","affiliation":[{"name":"First Department of Pathology, Faculty of Medicine, St. Anne\u2019s University Hospital, Faculty of Medicine, Masaryk University, 61200 Brno, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jana","family":"Zapletalov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Medical Biophysics, University Hospital, Faculty of Medicine and Dentistry, Palacky University Olomouc, 77900 Olomouc, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michal","family":"Mozo\u013ea","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacky University Olomouc, 77900 Olomouc, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"key":"ref_1","first-page":"209","article-title":"Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. 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