Caroline Rachael Anderson1, Katherine Sisson2, Marc Moncrieff3. 1. Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, United Kingdom. Electronic address: c.anderson@doctors.org.uk. 2. Department of Histopathology, Norfolk and Norwich University Hospitals, Colney Lane, Norwich NR4 7UY, United Kingdom. 3. Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, United Kingdom; Department of Plastic and Reconstructive Surgery, Norfolk and Norwich University Hospitals, Colney Lane, Norwich NR4 7UY, United Kingdom.
Abstract
OBJECTIVES: Excision margins for oral squamous cell carcinoma (OSCC) are poorly understood. Close (<5mm) and involved (<1mm) pathological margins are key indicators of the need for adjuvant treatment. This review aimed to assess the impact of pathological margin size on local recurrence rates. METHODS: MEDLINE and EMBASE were searched for studies that looked at local recurrence following excision of primary OSCC without adjuvant therapy. Five studies met the inclusion criteria. RESULTS: Recurrence rates were pooled to give a 21% absolute risk reduction (95% confidence interval 12-30%, p=<0.00001) in local recurrence with margins clear by more than 5mm. Unweighted pooled recurrence rates were 20% in patients with margins clear by more than 5mm. CONCLUSION: These findings suggest that a 5mm pathological margin is the minimum acceptable margin size in OSCC.
OBJECTIVES: Excision margins for oral squamous cell carcinoma (OSCC) are poorly understood. Close (<5mm) and involved (<1mm) pathological margins are key indicators of the need for adjuvant treatment. This review aimed to assess the impact of pathological margin size on local recurrence rates. METHODS: MEDLINE and EMBASE were searched for studies that looked at local recurrence following excision of primary OSCC without adjuvant therapy. Five studies met the inclusion criteria. RESULTS: Recurrence rates were pooled to give a 21% absolute risk reduction (95% confidence interval 12-30%, p=<0.00001) in local recurrence with margins clear by more than 5mm. Unweighted pooled recurrence rates were 20% in patients with margins clear by more than 5mm. CONCLUSION: These findings suggest that a 5mm pathological margin is the minimum acceptable margin size in OSCC.
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