Joseph Solomon1, Ashley Hinther1, T Wayne Matthews2,3, Steven C Nakoneshny3, Rob Hart2,3, Joseph C Dort2,3, Shamir P Chandarana4,5,6. 1. Cumming School of Medicine, University of Calgary, Calgary, Canada. 2. Department of Surgery, Section of Otolaryngology - Head & Neck Surgery, Calgary, Canada. 3. Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada. 4. Department of Surgery, Section of Otolaryngology - Head & Neck Surgery, Calgary, Canada. shamir.chandarana@ucalgary.ca. 5. Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada. shamir.chandarana@ucalgary.ca. 6. Foothills Medical Centre, North Tower Rm 1012, 1403 29 St NW, Calgary, AB, T2N 2T9, Canada. shamir.chandarana@ucalgary.ca.
Abstract
BACKGROUND: Close margins influence treatment and outcome in patients with oral squamous cell carcinoma (OSCC). This study evaluates 187 cases of surgically treated OSCC regarding the impact of close margins on recurrence-free survival (RFS) and disease-specific survival (DSS). METHODS: Predictors of worsened outcome were identified using Kaplan-Meier analysis and multivariate Cox regression analysis. RESULTS: Tumour size [HR:1.70(0.95-3.08)], nodal status [HR:2.15(1.00-4.64)], presence of extracapsular spread (ECS) [HR:6.36(2.41-16.74)] and smoking history [HR:2.87(1.19-6.86)] were associated with worsened RFS. Similar factors were associated with worsened DSS. Close margins did not influence RFS or DSS. CONCLUSIONS: While most conventional risk factors for OSCC conferred a worsened outcome, close margins did not. One explanation for this would be that close margins (< 5 mm) are equivalent to clear margins and the cutoff definition for a close margin should be re-evaluated. Lack of standardized pathology could also reduce accuracy of reporting of close surgical margins.
BACKGROUND: Close margins influence treatment and outcome in patients with oral squamous cell carcinoma (OSCC). This study evaluates 187 cases of surgically treated OSCC regarding the impact of close margins on recurrence-free survival (RFS) and disease-specific survival (DSS). METHODS: Predictors of worsened outcome were identified using Kaplan-Meier analysis and multivariate Cox regression analysis. RESULTS:Tumour size [HR:1.70(0.95-3.08)], nodal status [HR:2.15(1.00-4.64)], presence of extracapsular spread (ECS) [HR:6.36(2.41-16.74)] and smoking history [HR:2.87(1.19-6.86)] were associated with worsened RFS. Similar factors were associated with worsened DSS. Close margins did not influence RFS or DSS. CONCLUSIONS: While most conventional risk factors for OSCC conferred a worsened outcome, close margins did not. One explanation for this would be that close margins (< 5 mm) are equivalent to clear margins and the cutoff definition for a close margin should be re-evaluated. Lack of standardized pathology could also reduce accuracy of reporting of close surgical margins.
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
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Authors: L M Abbey; G E Kaugars; J C Gunsolley; J C Burns; D G Page; J A Svirsky; E Eisenberg; D J Krutchkoff; M Cushing Journal: Oral Surg Oral Med Oral Pathol Oral Radiol Endod Date: 1995-08
Authors: Alessia Di Rito; Francesco Fiorica; Roberta Carbonara; Francesca Di Pressa; Federica Bertolini; Francesco Mannavola; Frank Lohr; Angela Sardaro; Elisa D'Angelo Journal: Cancers (Basel) Date: 2022-07-29 Impact factor: 6.575
Authors: James Fowler; Yael Campanile; Andrew Warner; Francisco Laxague; Naif Fnais; Kevin Fung; Adrian Mendez; Danielle MacNeil; John Yoo; David Palma; Anthony Nichols Journal: J Otolaryngol Head Neck Surg Date: 2022-10-04