Abstract
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.
Keywords
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Article info
Publication history
Published online: July 11, 2011
Accepted:
May 16,
2011
Identification
Copyright
© 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
