Abstract
Aim: Surgical margin status in the resection of oral squamous cell carcinoma (OSCC) is a significant prognostic indicator of
recurrence and
long term outcome. We sought to investigate the factors (patient, tumour
and surgical) at time of surgery that influenced the ability to achieve
adequate surgical margins.
Method: We retrospectively reviewed patients who had undergone
primary resection of OSCC. Over a 4-year period (2012-2015) 100
patients were surgically treated. Histological derived margins were
classified as clear (≥5mm), close (<5mm) or involved (tumour present
at
resection margin).
Results: Overall, 49%, 45% and 6% had clear, close and
involved margins respectively. Of the 100 patients, 28 had stage I, 21
stages II,
7 stages III and 44 stage IV diseases. No relationship was evident
between margin status and sex, age (<65), surgical access or
individual
surgeon. Maximum tumour diameter and depth of invasion were significant
factors relating to poorer margins (p=0.015 and 0.021). Tumour
site appeared to have no impact upon margin status. The histological
feature of bone invasion had a significant impact upon poorer margins
(p=0.015), as did a positive node status (p=0.0054). We were unable to
correlate lymphovascular or perineural invasion with margin status.
Discussion: We highlight tumour factors which appear to
influence the margin status of resected OSCC, notably tumour size and
depth,
nodal spread and bone invasion. These all correlate to advanced stage
disease being more difficult to treat. Our findings further stress the
importance of being able to identify and delineate tumour mass
intra-operatively to facilitate a clear resection margin.
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.