Related Experiment Video
Updated: Mar 31, 2026
Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way
Published on: May 10, 2021
Margin to Depth of Invasion Ratio on Oncologic Outcomes in Node-Negative Oral Tongue Cancer
Kai-Shan Yang1, Yu-Tsai Lin1,2,3,4, Hui-Ching Chuang1,2,3
1Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Objective:
To evaluate the prognostic significance of the margin-to-depth of invasion ratio (MDR) in pathological nodal negative (pN0) oral tongue squamous cell carcinoma (OTSCC).
Study Design:
Case series with chart review.
Setting:
Tertiary academic medical center.
Methods:
Patients with pN0 OTSCC who underwent primary radical surgery and high-quality neck dissection (lymph node yield ≥18) without positive margin (<1 mm) between 2007 and 2017 were retrospectively analyzed. Cox proportional hazards models were utilized to identify factors associated with survival outcomes, including cancer-specific survival (CSS) and relapse-free survival (RFS).
Results:
A total of 296 patients were enrolled in this study. The optimal cutoff value for MDR was determined to be 0.29. For those with high MDR, the 5-year CSS and RFS were significantly superior compared to those with low MDR (CSS: 92.8% vs 71.5%, P < .001; RFS: 89.3% vs 67.9%, P < .001). In the multivariate Cox model, a low MDR remained an independent negative prognosticator of CSS (HR: 2.846, 95% CI: 1.229-6.593, P = .015) and RFS (HR: 2.661, 95% CI: 1.126-6.288, P = .026). In radical surgery without adjuvant therapy subgroup patients, patients with a low MDR had significantly poorer CSS and RFS than patients with a high MDR (both P < .001).
Conclusion:
Among pN0 OTSCC patients with negative surgical margins (≥1 mm), survival outcomes differed significantly between the high and low MDR groups. Patients with a low MDR had a markedly higher risk of recurrence and poorer cancer-specific survival, suggesting that adjuvant treatment may be warranted for this subgroup.
