Resection of early oral squamous cell carcinoma with positive or close margins: relevance of adjuvant treatment in relation to local recurrence: margins of 3 mm as safe as 5 mm

E.A. Dik, S.M. Willems, N.A. Ipenburg, S.O. Adriaansens, A.J.W.P. Rosenberg, R.J.J. van Es

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVES: The treatment strategy of early stage oral squamous cell carcinoma's (OSCC) resected with close or involved margins is a returning point of discussion. In this study we reviewed the consequences of re-resection (RR), postoperative radiotherapy (PORT) or watchful waiting (WW).

PATIENTS AND METHODS: Two-hundred patients with a primary resected Stage 1-2 OSCC of the tongue, floor of the mouth and cheek were included and retrospectively analysed. Local recurrence ratio was related to margin status, unfavourable histological parameters (spidery infiltrative, peri-neural and vascular-invasive growth) and postoperative treatment modality. 3-year overall survival (OS) and disease-specific survival (DSS) was calculated in relation to margin status.

RESULTS: Twenty-two of 200 (11%) patients had pathological positive margins (PM), 126 (63%) close margins (CM), and 52 (26%) free margins (FM). OS and DSS were not significantly different between these groups. Nine of 200 (4.5%) patients developed local recurrent disease. Two (9.1%) had a PM, five (4.0%) a CM and two (3.8%) a FM. Of the nine recurrences, five patients had undergone PORT, one a RR, and three follow-up. Watchful waiting for CM ⩾3 mm with ⩽2 unfavourable histological parameters showed, besides margin status no significant differences with the FM group.

CONCLUSION: With this treatment strategy, the local recurrence rate was 4.5%. No evidence was found for local adjuvant treatment in case of close margins ⩾3 mm with ⩽2 unfavourable histological parameters. Current data do not support the use of one treatment modality above any other.

Original languageEnglish
Pages (from-to)611-615
Number of pages5
JournalOral Oncology
Volume50
Issue number6
DOIs
Publication statusPublished - Jun 2014

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mouth Neoplasms
  • Neoplasm Recurrence, Local
  • Retrospective Studies
  • Survival Analysis
  • Watchful Waiting

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