The Impact of Surgical Margins of Oral Squamous Cell Carcinoma on Local Recurrence and Disease-Specific Survival
Positive margins for oral squamous cell carcinoma (OSCC) increase the risk for local recurrence and negatively impact disease-specific survival (1). Additionally, some researchers have shown that close surgical margins have the same impact (2), however the definition of a close margin is poorly standardized. In this study, we assessed the effect of precise width of the surgical margin on disease-specific survival and local recurrence.
Materials and methods
A retrospective chart review from July 1995 to June 2010 was conducted on patients with previously untreated, primary OSCC that were treated surgically at Harborview Medical Center or the University of Washington Medical Center. The width of the clear margin was obtained from histological measurements from the pathology report.
Methods of data analysis
Local recurrence and disease specific survival rates were calculated at 2 years and were compared using a chi-square test. A p value of <0.05 was considered to be significant.
Results
A total of 142 patients were identified. The local recurrence rate at 2 year follow up was 36.4% with margins 3mm or closer, and 15.4%, with margins greater than 3mm, P=0.17. Margin width did not appear to have a significant impact on disease specific survival.
Conclusions
A surgical margin ≤3 mm was associated with a higher local recurrence rate of OSCC. While the finding is not statistically significant, it reinforces previous studies highlighting the importance of obtaining adequate surgical margins. Large numbers of patients and long follow up times are difficult to obtain but essential.
References
1. T A Iseli, M J Lin, A Tsui, A Guiney, D Wiesenfeld and C E Iseli (2012). Are wider surgical margins needed for early oral tongue cancer?. The Journal of Laryngology & Otology, 126 , pp 289-294
2. Wong, L.S.; McMahon, J.; Devine, J.; McLellan, D.; 2. Thompson, E.; Farrow, A.; Moos, K.; Ayoub, A. Influence of close resection margins on local recurrence and disease-specific survival in oral and oropharyngeal carcinoma, British Journal of Oral and Maxillofacial Surgery, Volume 50, Issue 2, March 2012, Pages 102-108.