Prateek V Jain, Rajeev Sharan1, Kapila Manikantan1, Gary M Clark2, Sanjoy Chatterjee3, Indranil Mallick3, Paromita Roy4, Pattatheyil Arun5. 1. Department of Head and Neck Surgery, Tata Medical Center, Calcutta, West Bengal, 700160, India. 2. Gary Clark Statistical Consulting LLC, Superior, CO, USA. 3. Department of Radiation Oncology, Tata Medical Center, Calcutta, West Bengal, India. 4. Department of Pathology, Tata Medical Center, Calcutta, West Bengal, India. 5. Department of Head and Neck Surgery, Tata Medical Center, Calcutta, West Bengal, 700160, India. arunpattu@gmail.com.
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.
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.
Authors: Jay S Cooper; Thomas F Pajak; Arlene A Forastiere; John Jacobs; Bruce H Campbell; Scott B Saxman; Julie A Kish; Harold E Kim; Anthony J Cmelak; Marvin Rotman; Mitchell Machtay; John F Ensley; K S Clifford Chao; Christopher J Schultz; Nancy Lee; Karen K Fu Journal: N Engl J Med Date: 2004-05-06 Impact factor: 91.245
Authors: S Yamada; H Kurita; T Shimane; T Kamata; S Uehara; H Tanaka; T Yamamoto Journal: Int J Oral Maxillofac Surg Date: 2015-10-27 Impact factor: 2.789
Authors: David G Pfister; Sharon Spencer; David M Brizel; Barbara Burtness; Paul M Busse; Jimmy J Caudell; Anthony J Cmelak; A Dimitrios Colevas; Frank Dunphy; David W Eisele; Jill Gilbert; Maura L Gillison; Robert I Haddad; Bruce H Haughey; Wesley L Hicks; Ying J Hitchcock; Antonio Jimeno; Merrill S Kies; William M Lydiatt; Ellie Maghami; Renato Martins; Thomas McCaffrey; Loren K Mell; Bharat B Mittal; Harlan A Pinto; John A Ridge; Cristina P Rodriguez; Sandeep Samant; David E Schuller; Jatin P Shah; Randal S Weber; Gregory T Wolf; Frank Worden; Sue S Yom; Nicole R McMillian; Miranda Hughes Journal: J Natl Compr Canc Netw Date: 2014-10 Impact factor: 11.908