Margin Status and Local Recurrence in Early-Stage Oral-Cavity Squamous Cell Carcinoma: Analysis of Reresection...

Area of Science:

• Oncology
• Surgical Oncology
• Head and Neck Cancer Research

Background:

• Early-stage oral cavity squamous cell carcinoma (OCSCC) management relies on achieving clear surgical margins to minimize local recurrence (LR).
• The oncological safety of re-resected negative margins (RRN) compared to initial negative margins is not well-established.

Purpose of the Study:

• To evaluate the impact of initial surgical margin status and the need for re-resection on LR in early-stage OCSCC.
• To compare LR rates between initial negative, RRN, and positive margins in OCSCC patients.

Main Methods:

• Retrospective analysis of 352 patients with cT1-2N0 OCSCC treated between 2005 and 2024.
• Patients were categorized into initial negative margins (n=325), RRN (n=20), and positive margins (n=7).
• Local recurrence at 3 years was the primary outcome, analyzed using Chi-square tests and Cox proportional hazards models, adjusting for confounders like adjuvant therapy.

Main Results:

• Local recurrence rates were significantly higher for RRN (35.0%) and positive margins (42.9%) compared to initial negative margins (10.5%).
• Both positive (aHR 8.32) and RRN margins (aHR 3.82) were independently associated with increased LR after adjusting for adjuvant therapy and margin assessment method.
• No significant difference in LR was observed between positive and RRN margins (P=.374).

Conclusions:

• Re-resected negative margins are not oncologically equivalent to initial negative margins in early-stage OCSCC.
• Achieving clear margins on the initial resection is crucial for reducing local recurrence in OCSCC patients.