Impact of histological Oral Tongue Cancer margins on locoregional recurrence: A multi-centre retrospective analysis

Daniell, James R.; Udovicich, Cristian; Rowe, David; McDowell, Lachlan; Vital, Domenic; Bressel, Mathias; Magarey, Matthew; Iseli, Tim A.; Wong, To; Lekgabe, Ernest; Cavanagh, Karda; Fua, Tsien; Rischin, Danny; Wiesenfeld, D.

doi:10.1016/j.oraloncology.2020.105004

Cited by 13 publications

(6 citation statements)

References 35 publications

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“…Similarly, Fridman et al 20 analyzed 1257 patients of oral cavity squamous cell carcinoma in stage T1-2N0 (T1: 36.7%, T2: 63.3%) after surgery and reported the 5-year OS, DFS, disease-specific survival (DSS), and LRFS were 75%, 73%, 83%, and 79%, respectively. Besides, Daniell et al 21 also reported a similar distribution (T1: 53%, T2: 35%) with a 69% 5-year OS and a 75% 5-year freedom from loco-regional failure of 258 patients with postoperative TSCC from 2007 to 2016. In the present study, 89.3% of the patients received LND, with 50.2% having >15 LND.…”

Section: Discussionmentioning

confidence: 76%

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Prognostic factors in surgically treated tongue squamous cell carcinoma in stage T1‐2N0‐1M0: A retrospective analysis

Wang,

Zeng

et al. 2024

Cancer Medicine

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PurposeThe study aimed to retrospectively identify the prognostic factors of surgically treated primary tongue squamous cell carcinoma (TSCC) cases and assess the benefits of surgical neck lymph node dissection (LND) in early‐stage cancer.MethodsPatients with primary TSCC with pT1‐2N0‐1M0 stage without distant metastasis who were treated with surgery during 2014–2016 at Xiangya Hospital, Central South University were included. Univariate and multivariate Cox models were constructed to explore prognostic factors of overall survival (OS), disease‐free survival (DFS), and local recurrence‐free survival (LRFS). Sub‐group analysis was used to assess the effect of adjuvant therapy and the prognostic value of LND for the early‐stage patients.ResultsIn total, 440 patients met the inclusion criteria. During the follow‐up period, the 5‐year OS, DFS, were 84.4% and 70.0%, respectively. Univariate analysis showed that TNM stage, lymphovascular invasion (LVI), and/or perineural invasion (PNI), pathological differentiation, etc. were significant predictors of OS and DFS. Multivariate analysis showed that TNM stage and the degree of pathological differentiation were independent prognostic factors for all outcomes. Besides, the number of cervical LND could independently predict both DFS and LRFS while LVI/PNI were associated with DFS. And high‐quality neck LND (≥30) significantly improved DFS and LRFS for patients of pT1cN0M0 or stage I as compared to those without LND.ConclusionsTNM stage and pathological differentiation were crucial prognostic factors for postoperative patients with TSCC. Notably, high‐quality cervical LND was beneficial for the improvement of DFS and LRFS for patients of pT1cN0M0 or stage I.

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Section: Discussionmentioning

confidence: 76%

“…Besides, Daniell et al. 21 also reported a similar distribution (T1: 53%, T2: 35%) with a 69% 5‐year OS and a 75% 5‐year freedom from loco‐regional failure of 258 patients with postoperative TSCC from 2007 to 2016. In the present study, 89.3% of the patients received LND, with 50.2% having >15 LND.…”

Section: Discussionmentioning

confidence: 77%

Prognostic factors in surgically treated tongue squamous cell carcinoma in stage T1‐2N0‐1M0: A retrospective analysis

Wang,

Zeng

et al. 2024

Cancer Medicine

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“…The primary treatment for tongue cancer is surgery, aiming to remove the tumour and achieve a 5 mm histologic margin, termed a "clear" margin, around the tumour [17]. This involves the removal of affected lymph nodes in the neck and, when necessary, reconstruction with tissues to optimise function.…”

Section: Surgical Principlesmentioning

confidence: 99%

Optimising Patient Outcomes in Tongue Cancer: A Multidisciplinary Approach

de Boer,

Barnett,

Cardin

et al. 2024

Cancers

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A multidisciplinary approach to the management of tongue cancer is vital for achieving optimal patient outcomes. Nursing and allied health professionals play essential roles within the team. We developed symposia comprising a series of online lectures offering a detailed perspective on the role each discipline and consumer perspective has in the management of patients with tongue cancer. The topics, including epidemiology and prevention, diagnosis, treatment planning, surgery, adjuvant care, and the management of recurrent or metastatic disease, were thoroughly examined. The symposia highlighted the significance of fostering collaboration and continuous learning through a multidisciplinary approach. This initiative should be relevant to healthcare professionals, researchers, and policymakers striving to enhance patient outcomes in tongue cancer care through innovative collaboration.

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“…Approximately one-third of all head and neck cancers are oral squamous cell carcinoma (SCC) [ 1 ]. The preferred choice of treatment is complete surgical removal with histopathological adequate resection margins of the primary tumor to establish local control [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…There is still a discussion about the definition of an adequate margin. Several studies investigated the ideal histopathological cutoff margin [ 3 , 4 , 5 , 6 , 7 , 8 ]. Most guidelines define a free margin as ≥5 mm between the SCC and the resection plane [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Techniques That Define the Mucosal Margins of Oral Cancer In-Vivo: A Systematic Review

de Koning,

Adriaansens,

Noorlag

et al. 2024

Cancers

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Background: This systematic review investigates techniques for determining adequate mucosal margins during the resection of oral squamous cell carcinoma (SCC). The primary treatment involves surgical removal with ≥5 mm margins, highlighting the importance of accurate differentiation between SCC and dysplasia during surgery. Methods: A comprehensive Embase and PubMed literature search was performed. Studies underwent quality assessment using QUADAS-2. Results: After the full-text screening and exclusion of studies exhibiting high bias, eight studies were included, focusing on three margin visualization techniques: autofluorescence, iodine staining, and narrow-band imaging (NBI). Negative predictive value (NPV) was calculable across the studies, though reference standards varied. Results indicated NPVs for autofluorescence, iodine, and NBI ranging from 61% to 100%, 92% to 99%, and 86% to 100%, respectively. Autofluorescence did not significantly enhance margins compared to white light-guided surgery, while iodine staining demonstrated improvement for mild or moderate dysplasia. NBI lacked comparison with a white light-guided surgery cohort. Conclusions: We recommend studying and comparing the diagnostic accuracy of iodine staining and NBI in larger cohorts of patients with oral SCC, focusing on discriminating between SCC and (severe) dysplasia. Furthermore, we advise reporting the diagnostic accuracy alongside the treatment effects to improve the assessment of these techniques.

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Impact of histological Oral Tongue Cancer margins on locoregional recurrence: A multi-centre retrospective analysis

Cited by 13 publications

References 35 publications

Prognostic factors in surgically treated tongue squamous cell carcinoma in stage T1‐2N0‐1M0: A retrospective analysis

Prognostic factors in surgically treated tongue squamous cell carcinoma in stage T1‐2N0‐1M0: A retrospective analysis

Optimising Patient Outcomes in Tongue Cancer: A Multidisciplinary Approach

Intraoperative Techniques That Define the Mucosal Margins of Oral Cancer In-Vivo: A Systematic Review

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