The impact of pathologic close margin on the survival of patients with early stage oral squamous cell carcinoma.

Pathologic positive margin (PPM) has been proved to be an adverse prognostic factor for patients with oral squamous cell carcinoma (OSCC). Pathologic close margin (PCM) may occur as a result of limited resection. However, it's impact on the survival of early stage OSCC patients is relatively unclear. The medical records of all patients with early stage OSCC between 1999 and 2006 were reviewed. We analyzed 407 early stage OSCC patients, including 362 patients with pathologic safe margin (PSM), 14 patients with PPM and 31 patients with PCM. All patients with PCM didn't receive adjuvant radiotherapy, while 11 patients with PPM received adjuvant radiotherapy. The 5-year disease-free survival rates of patients with PSM, PPM and PCM were 78.2%, 61.4% and 50.8%, respectively (p=.002). The 5-year overall survival rates of patients with PSM, PPM and PCM were 91.2%, 85.1% and 70.1%, respectively (p=.001). On multivariate analyses using the Cox logistic regression method, PCM was the independent adverse prognostic factor for disease-free survival and overall survival (p=.002 and .006, respectively). Pathologic close margin is a poor prognostic factor for disease-free and overall survivals of patients with early stage OSCC. Postoperative adjuvant radiotherapy or revised surgery with a wider margin might be necessary for early stage OSCC patients with PCM.