Should sub-millimeter margins be deemed positive in oral cavity squamous cell carcinoma?,Oral Oncology

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Should sub-millimeter margins be deemed positive in oral cavity squamous cell carcinoma?
Oral Oncology ( IF 4.8 ) Pub Date : 2024-03-08 , DOI: 10.1016/j.oraloncology.2024.106745
Chung-Jan Kang , Li-Yu Lee , Shu-Hang Ng , Chien-Yu Lin , Kang-Hsing Fan , Wen-Cheng Chen , Jin-Ching Lin , Yao-Te Tsai , Shu-Ru Lee , Chih-Yen Chien , Chun-Hung Hua , Cheng Ping Wang , Tsung-Ming Chen , Shyuang-Der Terng , Chi-Ying Tsai , Hung-Ming Wang , Chia-Hsun Hsieh , Chih-Hua Yeh , Chih-Hung Lin , Chung-Kan Tsao , Nai-Ming Cheng , Tuan-Jen Fang , Shiang-Fu Huang , Li-Ang Lee , Ku-Hao Fang , Yu-Chien Wang , Wan-Ni Lin , Li-Jen Hsin , Tzu-Chen Yen , Yu-Wen Wen , Chun-Ta Liao

While several studies have indicated that a margin status of < 1 mm should be classified as a positive margin in oral cavity squamous cell carcinoma (OCSCC), there is a lack of extensive cohort studies comparing the clinical outcomes between patients with positive margins and margins < 1 mm. Between 2011 and 2020, we identified 18,416 Taiwanese OCSCC patients who underwent tumor resection and neck dissection. Of these, 311 had margins < 1 mm and 1013 had positive margins. To compare patients with margins < 1 mm and those with positive margins, a propensity score (PS)-matched analysis (n = 253 in each group) was conducted. The group with margins < 1 mm displayed a notably higher prevalence of several variables: 1) tongue subsite, 2) younger age, 3) smaller depth of invasion), 4) early tumor stage, and 5) treatment with surgery alone. Patients with margins < 1 mm demonstrated significantly better disease-specific survival (DSS) and overall survival (OS) rates compared to those with positive margins (74 % 53 %, 65 % 43 %, both < 0.0001). Multivariable analysis further confirmed that positive margins were an independent predictor of worse 5-year DSS (hazard ratio [HR] = 1.38, = 0.0103) and OS (HR = 1.28, = 0.0222). In the PS-matched cohort, the 5-year outcomes for patients with margins < 1 mm compared to positive margins were as follows: DSS, 71 % 59 %, respectively ( = 0.0127) and OS, 60 % 48 %, respectively ( = 0.0398). OCSCC patients with a margin status < 1 mm exhibited distinct clinicopathological characteristics and a more favorable prognosis compared to those with positive resection margins.

更新日期：2024-03-08

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