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Updated: May 14, 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: New Standard for T1/T2 OSCC Surgical Margin Assessment?
Ryo Takasaki1,2, Fumihiko Uchida2, Shohei Takaoka2
1Oral and Maxillofacial Surgery, Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan.
Objectives:
To identify factors associated with local recurrence of oral squamous cell carcinoma, with particular attention to the margin-to-depth-of-invasion ratio.
Methods:
We performed a retrospective cohort study of 98 patients with pathological T1 or T2 oral squamous cell carcinoma treated between 2013 and 2021. The prognostic relevance of clinicopathological variables-including resection-margin distance and the margin-to-depth-of-invasion ratio-was evaluated.
Results:
The margin-to-depth-of-invasion ratio was significantly associated with local recurrence (cutoff = 0.945, p = 0.014) and with disease-free survival (ratio < 0.945: 60.1%; ratio ≥ 0.945: 83.6%; p = 0.010); similar findings were observed for the close-margin subgroup (ratio < 0.945: 60.2%; ratio ≥ 0.945: 100%; p = 0.016). Close margins alone were not predictive of local recurrence (p = 0.258). In addition, no significant difference in disease-free survival was detected between cases with close margins and a ratio ≥ 0.945 and those with clear margins (100% vs. 80.2%; p = 0.094).
Conclusions:
The margin-to-depth-of-invasion ratio may serve as a practical criterion for determining the minimum resection distance and the need for postoperative adjuvant therapy in patients with close margins.
