There is a lack of consistency among published reports in the definition of what constitutes close resection margins (1–5 mm) in the surgical treatment of oral and oropharyngeal squamous cell carcinoma (SCC). Our aim was to define what would constitute close resection margins in predicting local recurrence and disease-specific survival. The study comprised 192 previously untreated patients with oral and oropharyngeal SCC who were recruited at the Southern General Hospital, Glasgow, from 2001 to 2007 with a minimum follow-up of 2 years. Resection was the primary treatment and the surgical margins were recorded for all patients. Statistical analyses were aided by the Statistical Package for the Social Sciences, version 15.0, and MedCalc software. The status of the surgical margins was evaluated using a receiver operating characteristic (ROC) curve to define the cut-off point. Cox's proportional hazard model was used to establish predictive factors for local recurrence and disease-specific survival. Of 192 patients, 23 (12%) had involved margins (<1.0 mm), 107 (56%) had close margins (1.0–2.0 mm (16.1%); 2.1–3.0 mm (12%); 3.1–4.0 mm (10.4%); 4.1–5.0 mm (17.2%), and 62 (32.3%) had clear margins (>5 mm). No predictive cut-off point was found that related close surgical margins to local recurrence. However, there was a significant adverse association between surgical margins ≤1.6 mm and disease-specific survival. In recommending postoperative adjuvant treatment for oral and oropharyngeal SCC, we suggest that surgical margins within 2 mm should be considered as the cut-off. However, other clinical and pathological prognostic factors should also be taken into consideration when recommending further treatment.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to British Journal of Oral and Maxillofacial Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Clinicopathological parameters and outcome of 245 patients operated for oral squamous cell carcinoma.J Craniomaxillofac Surg. 2006; 34: 344-350
- Survival following primary surgery for oral cancer.Oral Oncol. 2009; 45: 201-211
- Retrospective study of survival and treatment pattern in a cohort of patients with oral and oropharyngeal tongue cancers from 1987 to 2004.Oral Oncol. 2007; 43: 150-158
- Prognostic indicators for survival in head and neck squamous cell carcinomas: analysis of a series of 621 cases.Head Neck. 2005; 27: 801-808
- Oral cancer and precancerous lesions.CA Cancer J Clin. 2002; 52: 195-215
- The significance of “positive” margins in surgically resected epidermoid carcinomas.Head Neck Surg. 1978; 1: 107-111
- Significance of positive margins in oral cavity squamous carcinoma.Am J Surg. 1990; 160: 410-414
- The clinical significance of pathological findings in surgically resected margins of the primary tumor in head and neck carcinoma.Int J Radiat Oncol Biol Phys. 1987; 13: 833-837
- The status of the resection margin as a prognostic factor in the treatment of head and neck carcinoma.J Craniomaxillofac Surg. 1991; 19: 3141-3148
- Failure at the primary site following multimodality treatment in advanced head and neck cancer.Head Neck Surg. 1984; 6: 720-723
- Clinicopathological analysis of local spread of carcinoma of the tongue.Am J Surg. 1998; 175: 242-244
- The clinical significance of the positive surgical margin in oral cancer.Oral Oncol. 2007; 43: 780-784
- Factors affecting survival in patients with oral cancer: an Australian perspective.Int J Oral Maxillofac Surg. 2005; 34: 514-520
- The prognostic implications of the surgical margin in oral squamous cell carcinoma.Int J Oral Maxillofac Surg. 2003; 32: 30-34
- Datasets for histopathology reports on head and neck carcinoma and salivary neoplasms.2nd ed. Royal College of Pathologists, London2005
- Surgical excision margins: a pathologist's perspective.Adv Anat Pathol. 1999; 6: 140-148
- Survival and patterns of recurrence in 200 oral cancer patients treated by radical surgery and neck dissection.Oral Oncol. 1999; 35: 257-265
- Quantification of surgical margin shrinkage in the oral cavity.Head Neck. 1997; 19: 281-286
Published online: July 11, 2011
Accepted: May 16, 2011
© 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.