A bone of contention:Tumor - bone interaction in oral cancer

Oral cancer is becoming increasingly common and is an aggressive disease in which the tumor can invade the jawbone. This has major consequences for the extent of surgical treatment, reconstruction, and quality of life. Preoperatively, determining the degree of bone invasion remains challenging, which can lead to over- or undertreatment with significant clinical consequences. The aim of this dissertation is to improve the diagnostic accuracy of mandibular bone invasion in oral cancer by studying it from three perspectives: imaging, biomarkers, and oral health. A systematic review demonstrates that multimodal imaging, particularly the combination of MRI and CT, provides the highest predictive value. Biomarker research shows that bone-invasive oral cancer is characterized by changes in immune cell profiles and identifies GLUT-1 as a promising predictive biomarker. In addition, periodontitis—an inflammatory disease of the gingiva and jawbone—is strongly associated with mandibular tumor invasion and poorer clinical outcomes. Integrating these diagnostic approaches may lead to more accurate diagnosis, personalized treatment strategies, and targeted prevention.