The prognostic implications of the surgical margin in oral squamous cell carcinoma

Sutton, David; Brown, Jeremy; Rogers, Simon N.; Vaughan, E.D.; Woolgar, Julia A.

doi:10.1054/ijom.2002.0313

Cited by 332 publications

(276 citation statements)

References 15 publications

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“…The results of this study showed that a deep surgical margin had a significant impact on local recurrence, DSS, and RFS, as seen in previous studies [6,29,[39][40][41]. Some studies have identified an association between the margin status and factors that impact outcome in oral cancer, including the T status, N status, DOI, and POI [6,39,41].…”

Section: Discussionsupporting

confidence: 82%

Predictors of Locoregional Recurrence in T1-2N0 Tongue Cancer Patients

Yanamoto

Yamada

Takahashi

et al. 2013

Pathol. Oncol. Res.

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Locoregional recurrence of oral tongue squamous cell carcinoma (OTSCC) has been considered a poor prognostic entity in terms of survival rate.The purpose of this study was to evaluate the incidence of locoregional recurrence and to identify significant risk factors for locoregional recurrence in early-stage OTSCC. We retrospectively reviewed the records of 58 patients who underwent radical surgery for T1-2N0 OTSCC. The local recurrence and regional recurrence rates were 10.3% (6/58 patients) and 15.5% (9/58 patients) in this study, respectively. The survival rate of patients with local recurrence was 66.7%, which was significantly lower than that (96.2%) of patients without local recurrence, whereas the survival rates of patients with or without regional recurrence were not significantly difference. Pattern of invasion (POI), neoadjuvant chemotherapy (NAC) and the status of the surgical margin were identified as factors influencing local recurrence. In particular, the status of the deep surgical margin was a high potential independent risk factor. The deep surgical margin was resected closely in many NAC-treated cases, suggesting that NAC may lead to local recurrence and a poor outcome. No efficacy of NAC was observed, suggesting that the standard treatment for early OTSCC is surgery alone.

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Section: Discussionsupporting

confidence: 82%

Predictors of Locoregional Recurrence in T1-2N0 Tongue Cancer Patients

Yanamoto

Yamada

Takahashi

et al. 2013

Pathol. Oncol. Res.

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“…It is well accepted that patients demonstrating a positive surgical margin (dysplastic/cancerous epithelium within the surgical margin) have a higher incidence of local recurrence. [3][4][5][6] Previously we showed that vital staining with iodine solution could delineate the precise area of the dysplastic epithelium. 8 The dysplastic and cancerous epithelium was not stained with iodine solution, whereas the surrounding normal non-keratinized mucosa was stained brown-black.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] It has been shown that failure to achieve a clear surgical margin results in increased risk of local recurrence and a subsequently reduced chance of survival. [3][4][5][6] In oral cancer surgery, intraoperative margin assessment is usually performed using direct inspection and palpation and/or frozen section analysis; however, these methods have limitations in ensuring the complete resection of tumor and mucosal epithelium at a risk of malignancy. Vital staining with iodine solution has been employed intra-operatively with success in determining the extent and precise border of the cancerous/dysplastic epithelium, ensuring complete resection of the tumor at the mucosal surface.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of vital staining with iodine solution in reducing local recurrence after resection of dysplastic or malignant oral mucosa

Kitamura

Kamata

et al. 2012

British Journal of Oral and Maxillofacial Surgery

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Abstract.The purpose of this retrospective study was to assess the efficacy of vital staining with iodine solution in reducing local recurrence in the resection of dysplastic or cancerous oral mucosa.The conventional group (a historical control group) underwent surgical resection of dysplastic or cancerous mucosa solely by direct inspection/palpation. The vital staining group did with the aid of vital staining with iodine solution.Seven of 25 patients (28.0%) in the conventional group experienced recurrence of dysplastic or cancerous oral mucosa around the primary site, while no patient reported recurrence in the vital staining group (Fisher's exact probability test, p<0.01).Kaplan-Meier assessment showed that the 5-year primary-control rate was 100% in the vital staining group and 75% in the conventional group.Although this retrospective study has some limitations, the results suggested the possible value of the vital staining with iodine solution in reducing the incidence of recurrence of dysplastic or cancerous epithelium at the same site. Further well-controlled study is mandatory.

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“…Multiple factors have been studied regarding prognosis. 2,10 Tumors Ͼ2-to 4-mm thickness, with close or positive surgical margins, depth of invasion Ͼ2-4 mm, and metastasis to locoregional lymph nodes have all been implicated as determinants of prognosis 11 ; however, tumor thickness seems to be the only factor that has consistently shown promise as an indicator of risk for occult nodal metastasis. [12][13][14] Tumors Ͼ4 mm have a greater likelihood of metastasizing to the neck.…”

Section: Discussionmentioning

confidence: 99%

Gauze Padding: A Simple Technique to Delineate Small Oral Cavity Tumors

Dillon¹,

Glastonbury²,

Jabeen³

et al. 2011

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Small oral cavity tumors are an imaging challenge. Intimate apposition of vestibular oral mucosa to the alveolar mucosa makes tumor assessment difficult. In CT imaging, the "puffed cheek" method has been used to separate surfaces, though this is not feasible with long MR imaging sequences. We implemented placement of 2 ϫ 2 inch (6.45 cm) gauze into the oral vestibule before the MR imaging examination, to determine whether this might improve tumor visualization.

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The prognostic implications of the surgical margin in oral squamous cell carcinoma

Cited by 332 publications

References 15 publications

Predictors of Locoregional Recurrence in T1-2N0 Tongue Cancer Patients

Predictors of Locoregional Recurrence in T1-2N0 Tongue Cancer Patients

Effectiveness of vital staining with iodine solution in reducing local recurrence after resection of dysplastic or malignant oral mucosa

Gauze Padding: A Simple Technique to Delineate Small Oral Cavity Tumors

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