Risk factors in securing successful surgical resection of oral squamous cell carcinoma

Abstract

The purpose of this retrospective study was to analyze the factors that had a significant effect on securing a successful surgical resection (surgical margin) in oral cancer surgery. One hundred forty‐eight consecutive patients who underwent planned radical resection of oral squamous cell carcinoma (SCC) were analyzed. Successful resection was judged if pathological examination of the surgical specimen revealed a clear surgical margin (no SCC within 5 mm, n = 116), while an unsuccessful resection was judged if there was a close and involved surgical margin (SCC within 5 mm, n = 21; and SCC at margin, n = 11). Univariate analyses showed that gender, age, and T‐classification had significant influence on successful surgical resection. The results of multivariate logistic regression analysis showed that age (odds ratio [OR] = 1.042, 95% CI = 1.001‐1.084), T‐classification (OR = 1.656, 95% CI = 1.060‐2.587), and the presence of preoperative treatment (OR = 2.868, 95% CI = 1.047‐7.85) had significant effects on successful surgical resection. The results of this study suggested that successful resection of oral SCC was difficult in patients with either older age or advanced (T4) tumor. It is also suggested that preoperative therapy had a positive effect on securing a pathologically clear surgical margin.

Clinicopathological characteristics predicting advanced stage and surgical margin invasion of oral squamous cell carcinoma: A single‑center study on 10 years of cancer registry data

“…Almost 15% of cases in the present study demonstrated invaded surgical margins, similar to findings in previous studies (17–44% inadequate surgical margins) ( 11 , 99 – 101 ); however, one study reported a lower proportion of invaded margins (7.5%) ( 28 ). In OSCC, assessing surgical margins is a crucial part of determining the therapeutic outcome, while also considering tumor location, tumor stage, tissue shrinkage and mucosal elasticity ( 102 ).…”

“…It also has been acknowledged as enormously impactful on the survival outcomes of patients treated surgically for oral cancer ( 127 ). In previous studies, the ability to achieve a wide free margin was linked with some clinical aspects, such as age, sex, the epicenter of the tumor, T and N status, and treatment modality ( 11 , 99 , 125 , 126 , 128 , 129 ). However, occasionally, oral surgeons cannot acquire an adequate surgical margin for OSCC, as the oral cavity has a complicated anatomy, and wider resection might cause more significant disfiguration or functional disability.…”

“…Compared to the tongue as a reference, the present study demonstrated that based on the tumor subsite, mouth NOS and palate had a higher chance to result in poor tumor outcomes due to their likelihood to have invaded surgical margins. The tongue was used as a reference as it had the fewest amount of cases with positive surgical margins, and following other studies, which commonly used the tongue as a reference in OSCC analysis ( 11 , 28 , 99 , 102 , 131 , 132 ). The anatomy of the tongue permits the design and adaptation of a hemiglossectomy adequate for achieving clear margins ( 102 ).…”

“…However, this concept remains controversial and requires further investigation into prognosis-related factors ( 9 ). Two of the most definite prognosis-related factors to have been reported are advanced stage and invasion of surgical margins ( 10 , 11 ), which can be predicted by understanding the role of clinicopathological characteristics of OSCC. However, these parameters have not been widely investigated.…”

Collagen cross‐linking in oral cancer

“…GLOBOCAN 2020, a database of global cancer statistics, reported that 377 713 people were newly diagnosed with lip and oral cancer in 2020 1 . Currently, the most common treatment for these cancers is complete surgical removal 2–4 . However, these surgeries can have complications including impairment of mastication, swallowing, and articulation.…”