Development and validation of nomograms for ameloblastoma recurrence prediction: a multinational, two-center study from Seoul, South Korea and Wuhan, China

Abstract

ObjectiveThis study aimed to construct and validate region-specific nomograms to predict ameloblastoma recurrence and to investigate potential geographic differences in recurrence-related risk factors between South Korea and China.Materials and methodsA total of 816 patients with ameloblastoma treated between 2006 and 2023 were retrospectively analyzed from Yonsei University Dental Hospital (n = 372) and Hospital of Stomatology, Wuhan University (n = 444). Demographic, radiographic, and pathological variables were collected. Logistic regression analysis identified recurrence-associated predictors. Separate nomograms were developed and internally validated for each cohort. Model performance was evaluated using the area under the curve (AUC), calibration curves, and decision curve analysis.ResultsThe South Korean nomogram incorporated six variables, including pathological type, malignant transformation, surgical method, imaging type, tumor size, and cortical bone destruction (AUC = 0.757). The Chinese model incorporated eight predictors, including sex, root resorption, and number of involved teeth (AUC = 0.787). Calibration and decision curves indicated strong agreement between predicted and observed outcomes and favorable clinical applicability.ConclusionsBoth nomograms demonstrated good predictive accuracy and highlighted regional differences in risk factors. These findings support the integration of multicenter data to enhance recurrence prediction in ameloblastoma.Clinical relevanceThe developed tools can guide individualized treatment planning and long-term follow-up, aiding clinicians in early identification of high-risk patients and optimizing surgical strategies.