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Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way
Published on: May 10, 2021
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Close Resection Margins Do Not Influence Local Recurrence in Patients With Oral Squamous Cell Carcinoma: A
Panagiotis Stathopoulos1, William P Smith2
1Associate Professor, Dublin Dental University Hospital; Consultant Oral and Maxillofacial Surgeon, St James and Mater Hospitals, Dublin, Ireland.
Summary
Close surgical margins in oral squamous cell carcinoma do not significantly predict local recurrence. Reassessing this strategy is crucial, as other factors like lymph node involvement and tumor depth are more critical for treatment decisions.
Area of Science:
- Oncology
- Surgical Pathology
- Oral Cancer Research
Background:
- Oral squamous cell carcinoma (OSCC) is a common malignancy.
- Surgical resection is a primary treatment modality for OSCC.
- The significance of resection margin status in predicting local recurrence is debated.
Purpose of the Study:
- To investigate the clinical relevance of the distance between resection margins and tumor cells in OSCC.
- To determine the association between close resection margins and local recurrence rates in OSCC.
Main Methods:
- Retrospective analysis of 53 OSCC patients treated surgically between 1995 and 2006.
- Exclusion criteria included dysplasia, prior radiotherapy, and non-OSCC deaths.
- Margins were classified as 'close' (1-5 mm) or 'clear' (≥5 mm); local recurrence was defined as tumor reappearance within 5 years.
Main Results:
- 32 patients had clear margins, with 3 local recurrences.
- 21 patients had close margins, with 3 local recurrences.
- No statistically significant difference in local recurrence rates was observed between the clear and close margin groups.
Conclusions:
- Close resection margins in OSCC may not be a reliable indicator for local recurrence or adverse prognosis.
- Histopathologic evidence of tumor cells near margins (<0.5 cm) does not automatically necessitate further treatment.
- Prognostic factors such as cervical lymph node involvement and tumor depth are essential for guiding subsequent treatment decisions.
