The status of the deep surgical margins in tongue and floor of mouth squamous cell carcinoma and risk of local recurrence; an analysis of 68 patients

Weijers, M.; Snow, Gordon B.; Bezemer, Dick; Wal, Jacqueline E. van der; Waal, I. van der

doi:10.1054/ijom.2002.0469

Cited by 60 publications

(51 citation statements)

References 12 publications

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“…The definition of local failure versus a second primary tumor also lacks uniformity. 13,17,19 Some authors incorporate elapsed time into the distinction; for instance, van Es et al and Slootweg et al considered any lesion that occurred after 2 years of followup as a second primary tumor rather than a local recurrence regardless of site in relation to the index lesion. 13,17 Although molecular profiling can potentially increase the accuracy of distinguishing a lesion as a local recurrence or a second primary tumor, currently, it largely remains a research tool.…”

Section: Discussionmentioning

confidence: 99%

Close margin alone does not warrant postoperative adjuvant radiotherapy in oral squamous cell carcinoma

Ch’ng

Corbett-Burns

Stanton

et al. 2013

Cancer

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BACKGROUND: There are major variations between institutions regarding postoperative adjuvant therapy for adverse features in patients with oral squamous cell carcinoma (SCC). The authors' practice has been to not recommend any adjuvant therapy on the basis of close (<5 mm but uninvolved) margins unless there are additional adverse features. The primary objective of this study was to assess whether the local control achieved in this patient cohort was acceptable. METHODS: In this single-institution, retrospective analysis, local control was the primary endpoint, and disease-specific survival (DSS) was the secondary endpoint. Differences in survival were determined using the log-rank test, and survival curves were generated using the Kaplan-Meier method. RESULTS: One hundred forty-four patients (79 men and 65 women; median age, 64.1 years; mean follow-up, 3.3 years) underwent surgery alone for oral SCC with curative intent and were recorded as having close tumor margins on histology. The local control rate for all patients who underwent surgery alone was 91% (95% confidence interval, 81.9%-95.2%), and the DSS rate was 84% (95% confidence interval, 74.0%-89.9%) at 5 years. There was no pattern of worse local control or DSS rates with the ordered stratification of close margins. The 5-year local control rates for having 0, 1, 2, and 3 additional adverse features were 100%, 96%, 83%, and 71%, respectively (P 5.004; trend test). CONCLUSIONS: Surgery alone without postoperative adjuvant therapy offered acceptable local control in patients who had close margin status as their only adverse feature and may be reasonable in the presence of 1 other adverse clinicopathologic feature.

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Section: Discussionmentioning

confidence: 99%

Close margin alone does not warrant postoperative adjuvant radiotherapy in oral squamous cell carcinoma

Ch’ng

Corbett-Burns

Stanton

et al. 2013

Cancer

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“…Amaral and colleagues studied 188 patients with clinical Stage I/II oral SCC; they found that the disease-free and overall survival rates were unaffected by margin status (5 mm standard) [32]. Weijers reported on 68 patients, all stages, with oral SCC, and found no significant differences in locoregional recurrence between patient groups for negative (2/30 or 6.6%) and close margins (\5 mm, 3/38 or 7.9%), after the exclusion of patients with frankly positive (''cut through'') margins [33]. Similarly, we found no significant differences in locoregional recurrence between patient groups for negative (28/119, or 23.5%) and close margins (\5 mm, 4/30 or 13%), after the exclusion of 19 patients with frankly positive (''cut through'') margins [25].…”

Section: The Prognostic Significance Of Resection Marginsmentioning

confidence: 99%

Prognostic Indicators in Head and Neck Oncology Including the New 7th Edition of the AJCC Staging System

Brandwein-Gensler

Smith

2010

Head and Neck Pathol

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“…The prognostic significance of surgical margin for LR of head and neck cancer and oral tongue cancer has been reported [1,[14][15][16] and it was confirmed as a risk factor when \5 mm of margin status was encountered even though the patients had postoperative adjuvant therapy. Tumor thickness has been considered to correlate with cervical lymph node metastasis but there is no clear consensus of how to measure depth or thickness and also the decisive cut-off level for elective neck treatment.…”

Section: Discussionmentioning

confidence: 88%

“…From the statistic evaluation, the thickness of [7 mm is the cut point which significantly affected LR and interestingly, there was no correlation with RR. The postulation is when the tumor depth increases, the possibility of clear deep surgical margin may be affected and there is a study which has reported the status of deep surgical margins as a risk of LR [16].…”

Section: Discussionmentioning

confidence: 99%

“…The presence of PVI, PLI and PNI are identified as predictors of occult neck metastasis [16] and the clinical trial published in 2004 [14] has demonstrated benefits in the locoregional control of adjuvant therapy in patients with these histo-pathological features. The results of the present study revealed PVI and PLI have statistical significance in both LR and RR but PNI has not.…”

Section: Discussionmentioning

confidence: 99%

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Impact of Clinical and Histo-Pathological Prognostic Factors on T1-2N0-1 Oral Tongue Carcinoma

Sittitrai

Srivanitchapoom

Mahanupab

et al. 2012

Indian J Otolaryngol Head Neck Surg

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To determine predictive factors which affect local and regional recurrence of T1-2N0-1M0 oral tongue carcinoma (OTC). Records of 42 patients with T1-2N0-1 M0 OTC were reviewed. The clinical characteristics, histopathological data, disease recurrence and survival rate were analyzed. Descriptive statistics and Kaplan-Meier survival analysis were used. The median follow up was 38 months. The 2-year overall survival and disease-free survival rates were 85.7 and 55.6 % respectively. At the 2 year analysis, there were surgical margin\5 mm (p value = 0.01), tumor thickness [7 mm (p value = 0.03), perivascular and perilymphatic invasion (p value = 0.01) affected on local recurrence and perivascular and perilymphatic invasion were also predictors for regional recurrence (p value = 0.04). The surgical margin status, tumor thickness, perivascular and perilymphatic invasion represented significant predictive factors for local recurrent OTC. Postoperative adjuvant therapy should be considered in these groups.

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The status of the deep surgical margins in tongue and floor of mouth squamous cell carcinoma and risk of local recurrence; an analysis of 68 patients

Cited by 60 publications

References 12 publications

Close margin alone does not warrant postoperative adjuvant radiotherapy in oral squamous cell carcinoma

Close margin alone does not warrant postoperative adjuvant radiotherapy in oral squamous cell carcinoma

Prognostic Indicators in Head and Neck Oncology Including the New 7th Edition of the AJCC Staging System

Impact of Clinical and Histo-Pathological Prognostic Factors on T1-2N0-1 Oral Tongue Carcinoma

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