Redefining adequate margins in oral squamous cell carcinoma: outcomes from close and positive margins

European Archives of Oto-Rhino-Laryngology

pp 1–11| Cite as

Redefining adequate margins in oral squamous cell carcinoma: outcomes from close and positive margins

Authors
Authors and affiliations

Prateek V. Jain
Rajeev Sharan
Kapila Manikantan
Gary M. Clark
Sanjoy Chatterjee
Indranil Mallick
Paromita Roy
Pattatheyil Arun
















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Head and Neck
First Online: 02 January 2020
Abstract

Purpose

Adequacy of surgical margins impacts outcomes in oral cancer. We sought to determine whether close and positive margins have different outcomes in patients with oral cancer.

Methods

Retrospective data from 612 patients with oral carcinoma were analyzed for the effect of margin status on locoregional recurrence-free survival (LRFS), disease-free survival (DFS) and overall survival (OS).

Results

A total of 90 cases (14.7%) had close margins and 26 patients (4.2%) had positive margins. Recurrences were documented in 173 patients (28%), of which 137 (22% of the study sample) were locoregional, and 164 patients (27%) had died. Among patients with close or positive margins, a cutoff of 1 mm optimally separated LRFS (adjusted p = 0.0190) and OS curves (adjusted p = 0.0168) whereas a cutoff of 2 mm was sufficient to significantly separate DFS curves (adjusted p = 0.0281).

Conclusions

Patients with oral carcinoma with positive margins (< 1 mm) had poorer outcomes compared to those with close margins (1–5 mm) in terms of LRFS, DFS and OS. There is a suggestion that a cutoff of < 2 mm might provide slightly more separation for DFS.

KeywordsOral squamous cell carcinoma Survival analysis Surgical margin status Close margins Positive margins


This research was presented as a poster in FHNO and IFHNOS conference held in Kolkata in 2018.
Electronic supplementary material

The online version of this article ( https://doi.org/10.1007/s00405-019-05779-w) contains supplementary material, which is available to authorized users.