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European Archives of Oto-Rhino-Laryngology

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01-04-2020 | Head and Neck

Redefining adequate margins in oral squamous cell carcinoma: outcomes from close and positive margins

Authors: Prateek V. Jain, Rajeev Sharan, Kapila Manikantan, Gary M. Clark, Sanjoy Chatterjee, Indranil Mallick, Paromita Roy, Pattatheyil Arun

Published in: European Archives of Oto-Rhino-Laryngology | Issue 4/2020

Abstract

Purpose

Adequacy of surgical margins impacts outcomes in oral cancer. We sought to determine whether close and positive margins have different outcomes in patients with oral cancer.

Methods

Retrospective data from 612 patients with oral carcinoma were analyzed for the effect of margin status on locoregional recurrence-free survival (LRFS), disease-free survival (DFS) and overall survival (OS).

Results

A total of 90 cases (14.7%) had close margins and 26 patients (4.2%) had positive margins. Recurrences were documented in 173 patients (28%), of which 137 (22% of the study sample) were locoregional, and 164 patients (27%) had died. Among patients with close or positive margins, a cutoff of 1 mm optimally separated LRFS (adjusted p = 0.0190) and OS curves (adjusted p = 0.0168) whereas a cutoff of 2 mm was sufficient to significantly separate DFS curves (adjusted p = 0.0281).

Conclusions

Patients with oral carcinoma with positive margins (< 1 mm) had poorer outcomes compared to those with close margins (1–5 mm) in terms of LRFS, DFS and OS. There is a suggestion that a cutoff of < 2 mm might provide slightly more separation for DFS.

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Title: Redefining adequate margins in oral squamous cell carcinoma: outcomes from close and positive margins
Authors: Prateek V. Jain
Rajeev Sharan
Kapila Manikantan
Gary M. Clark
Sanjoy Chatterjee
Indranil Mallick
Paromita Roy
Pattatheyil Arun
Publication date: 01-04-2020
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 4/2020
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-019-05779-w

At a glance: The STEP trials

Springer Medicine

Redefining adequate margins in oral squamous cell carcinoma: outcomes from close and positive margins

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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