How Does the Close Surgical Margin Impact Recurrence and Survival When Treating Oral Squamous Cell Carcinoma?

Risk factors for salvage surgery failure in oral cavity squamous cell carcinoma

“…The ability to obtain free surgical margins at the end of the operation is a good prognostic factor. In a study with 54 patients who underwent surgical treatment for SCC of the oral cavity, the clear surgical margin group (>5 mm) had higher disease‐free survival rates than patients with close margins (<5 mm) and involved margins (5‐year probability of 0.78 vs. 0.43 and 0.29, respectively; P = .014 with a trend toward increased overall survival at 2 and 5 years [ P = .093]) …”

“…In a study with 54 patients who underwent surgical treatment for SCC of the oral cavity, the clear surgical margin group (>5 mm) had higher disease-free survival rates than patients with close margins (<5 mm) and involved margins (5-year probability of 0.78 vs. 0.43 and 0.29, respectively; P 5 .014 with a trend toward increased overall survival at 2 and 5 years [P 5 .093]). 20 The use of frozen section techniques to evaluate intraoperative margins is advisable 21 and is routinely employed in our service. Varvares et al 22 demonstrated that the presence of free surgical margins in frozen sections, when assessed from the resected specimen rather than the tumor bed, consistently predicted local control.…”

Proceedings: Pathways for Successful Translation of New Imaging Agents and Modalities—Phase III Studies

“…Patients with positive margins have worse 2and 5-y survival rates; this has been shown fairly consistently (41,45,46). Survival with negative margins is somewhere between 65% and 90%, but that with positive margins is less than 50%, roughly a 30% difference (40,41,44,45). This difference is seen for both early-stage and advanced-stage disease.…”

“…Margins have a significant impact on overall survival. The positive margin rate ranges from 20% to 30% (40)(41)(42)(43)(44). The 5-y survival rate varies for those with positive versus close versus negative margins.…”

How Close Are We to Real Time Optical Margin Control in Head and Neck Oncologic Surgery?

“…Several studies have indicated that close, or positive margins after oncologic head and neck surgery results in poor outcomes, in terms of disease free survival and overall survival [42] . There continues to exist significant technical and oncological limitations regarding the current standard of care, namely histologic frozen section surgical margins.…”