Validity and utility of cat classification system for oncological mandibular defects A multi-institutional study

Kazunobu Hashikawa, Shinya Tahara, Daisuke Sugiyama, Satoshi Yokoo, Ikuo Hyodo, Hisashi Motomura, Tateki Kubo, Tomoyuki Kurita, Seiichi Yoshimoto, Akihiko Takushima, Tetsuro Yamashita, Minoru Sakuraba, Kazuhiro Yagihara, Masahiro Nakagawa, Tomoyuki Yano, Katsuhiro Ishida, Hiroyuki Sakurai, Yasunobu Terao, Katsumi Tanaka, Yoshihiro Kimata

Research output: Contribution to journalArticle

Abstract

Background: We have previously proposed the CAT classification system, a simple and clear-cut system for classifying segmental mandibular defects after oncological surgery: “C” refers to the loss of the condylar head of the mandible, “A” the mandibular angle and “T” the mental tubercle. Here, we report a statistical and mathematical taxonomical study on the validity and utility of the classification system. Methods: Data were collected from 17 medical institutions in Japan on 259 patients who had undergone surgical ablation and simultaneous microsurgical oromandibular reconstruction (osteocutaneous free flap or soft tissue free flap with reconstruction-plate) attributed to head and neck cancer. The mandibular defects were classified according to the CAT system and the two commonly used systems HCL and Urken, and the validity and utility of the CAT system were tested as follows: 1) the tendency among the numbers of the three reference points of the CAT system (C, A and T) and the esthetic outcome of each patient were analyzed by Jonckheere's trend test, 2) each of the classified patterns of the three systems was analyzed by cluster analysis based on the esthetic results using Ward's method. Results: 1) There was a statistically significant trend among the numbers of the three reference points in the CAT system and the esthetic outcome, 2) each of the grouped clusters in the CAT system was clinically explicable and demonstrated a significant difference in the esthetic outcome; the two other systems did not yield such information. Conclusion: The CAT classification system is valid and useful for oncological segmental mandibular defects.

Original languageEnglish
Pages (from-to)309-315
Number of pages7
JournalToukeibu Gan
Volume36
Issue number3
DOIs
Publication statusPublished - 2010
Externally publishedYes

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Esthetics
Cats
Free Tissue Flaps
Head and Neck Neoplasms
Mandible
Cluster Analysis
Japan

Keywords

  • Classification system
  • Head and neck cancer
  • Head and neck reconstruction
  • Mandibular defect
  • Mandibular reconstruction

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Oncology

Cite this

Validity and utility of cat classification system for oncological mandibular defects A multi-institutional study. / Hashikawa, Kazunobu; Tahara, Shinya; Sugiyama, Daisuke; Yokoo, Satoshi; Hyodo, Ikuo; Motomura, Hisashi; Kubo, Tateki; Kurita, Tomoyuki; Yoshimoto, Seiichi; Takushima, Akihiko; Yamashita, Tetsuro; Sakuraba, Minoru; Yagihara, Kazuhiro; Nakagawa, Masahiro; Yano, Tomoyuki; Ishida, Katsuhiro; Sakurai, Hiroyuki; Terao, Yasunobu; Tanaka, Katsumi; Kimata, Yoshihiro.

In: Toukeibu Gan, Vol. 36, No. 3, 2010, p. 309-315.

Research output: Contribution to journalArticle

Hashikawa, K, Tahara, S, Sugiyama, D, Yokoo, S, Hyodo, I, Motomura, H, Kubo, T, Kurita, T, Yoshimoto, S, Takushima, A, Yamashita, T, Sakuraba, M, Yagihara, K, Nakagawa, M, Yano, T, Ishida, K, Sakurai, H, Terao, Y, Tanaka, K & Kimata, Y 2010, 'Validity and utility of cat classification system for oncological mandibular defects A multi-institutional study', Toukeibu Gan, vol. 36, no. 3, pp. 309-315. https://doi.org/10.5981/jjhnc.36.309
Hashikawa, Kazunobu ; Tahara, Shinya ; Sugiyama, Daisuke ; Yokoo, Satoshi ; Hyodo, Ikuo ; Motomura, Hisashi ; Kubo, Tateki ; Kurita, Tomoyuki ; Yoshimoto, Seiichi ; Takushima, Akihiko ; Yamashita, Tetsuro ; Sakuraba, Minoru ; Yagihara, Kazuhiro ; Nakagawa, Masahiro ; Yano, Tomoyuki ; Ishida, Katsuhiro ; Sakurai, Hiroyuki ; Terao, Yasunobu ; Tanaka, Katsumi ; Kimata, Yoshihiro. / Validity and utility of cat classification system for oncological mandibular defects A multi-institutional study. In: Toukeibu Gan. 2010 ; Vol. 36, No. 3. pp. 309-315.
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abstract = "Background: We have previously proposed the CAT classification system, a simple and clear-cut system for classifying segmental mandibular defects after oncological surgery: “C” refers to the loss of the condylar head of the mandible, “A” the mandibular angle and “T” the mental tubercle. Here, we report a statistical and mathematical taxonomical study on the validity and utility of the classification system. Methods: Data were collected from 17 medical institutions in Japan on 259 patients who had undergone surgical ablation and simultaneous microsurgical oromandibular reconstruction (osteocutaneous free flap or soft tissue free flap with reconstruction-plate) attributed to head and neck cancer. The mandibular defects were classified according to the CAT system and the two commonly used systems HCL and Urken, and the validity and utility of the CAT system were tested as follows: 1) the tendency among the numbers of the three reference points of the CAT system (C, A and T) and the esthetic outcome of each patient were analyzed by Jonckheere's trend test, 2) each of the classified patterns of the three systems was analyzed by cluster analysis based on the esthetic results using Ward's method. Results: 1) There was a statistically significant trend among the numbers of the three reference points in the CAT system and the esthetic outcome, 2) each of the grouped clusters in the CAT system was clinically explicable and demonstrated a significant difference in the esthetic outcome; the two other systems did not yield such information. Conclusion: The CAT classification system is valid and useful for oncological segmental mandibular defects.",
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T1 - Validity and utility of cat classification system for oncological mandibular defects A multi-institutional study

AU - Hashikawa, Kazunobu

AU - Tahara, Shinya

AU - Sugiyama, Daisuke

AU - Yokoo, Satoshi

AU - Hyodo, Ikuo

AU - Motomura, Hisashi

AU - Kubo, Tateki

AU - Kurita, Tomoyuki

AU - Yoshimoto, Seiichi

AU - Takushima, Akihiko

AU - Yamashita, Tetsuro

AU - Sakuraba, Minoru

AU - Yagihara, Kazuhiro

AU - Nakagawa, Masahiro

AU - Yano, Tomoyuki

AU - Ishida, Katsuhiro

AU - Sakurai, Hiroyuki

AU - Terao, Yasunobu

AU - Tanaka, Katsumi

AU - Kimata, Yoshihiro

PY - 2010

Y1 - 2010

N2 - Background: We have previously proposed the CAT classification system, a simple and clear-cut system for classifying segmental mandibular defects after oncological surgery: “C” refers to the loss of the condylar head of the mandible, “A” the mandibular angle and “T” the mental tubercle. Here, we report a statistical and mathematical taxonomical study on the validity and utility of the classification system. Methods: Data were collected from 17 medical institutions in Japan on 259 patients who had undergone surgical ablation and simultaneous microsurgical oromandibular reconstruction (osteocutaneous free flap or soft tissue free flap with reconstruction-plate) attributed to head and neck cancer. The mandibular defects were classified according to the CAT system and the two commonly used systems HCL and Urken, and the validity and utility of the CAT system were tested as follows: 1) the tendency among the numbers of the three reference points of the CAT system (C, A and T) and the esthetic outcome of each patient were analyzed by Jonckheere's trend test, 2) each of the classified patterns of the three systems was analyzed by cluster analysis based on the esthetic results using Ward's method. Results: 1) There was a statistically significant trend among the numbers of the three reference points in the CAT system and the esthetic outcome, 2) each of the grouped clusters in the CAT system was clinically explicable and demonstrated a significant difference in the esthetic outcome; the two other systems did not yield such information. Conclusion: The CAT classification system is valid and useful for oncological segmental mandibular defects.

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KW - Classification system

KW - Head and neck cancer

KW - Head and neck reconstruction

KW - Mandibular defect

KW - Mandibular reconstruction

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