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| Oral oncology. 2016 Feb 6. pii: S1368-8375(16)00013-0. doi: 10.1016/j.oraloncology.2016.01.010 |
| Margin to tumor thickness ratio - A predictor of local recurrence and survival in oral squamous cell carcinoma. |
| Heiduschka G1, Virk SA2, Palme CE3, Ch'ng S4, Elliot M5, Gupta R6, Clark J7 |
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Abstract OBJECTIVES: To assess whether small oral squamous cell carcinomas (OSCC) require the same margin clearance as large tumors. We evaluated the association between the ratio of the closest margin to tumor size (MSR) and tumor thickness (MTR) with local control and survival. METHODS AND METHODS: The clinicopathologic and follow up data were obtained for 501 OSCC patients who had surgical resection with curative intent at our institution. MTR and MSR were computed and their associations with local control and survival were assessed using multivariable Cox-regression model. Survival curves were generated using the Kaplan-Meier method. RESULTS: MTR was a better predictor of disease control than MSR. MTR was a predictor of local failure (p=0.033) and disease specific death (p=0.038) after adjusting for perineural invasion, lymphovascular involvement, nodal status, and radiotherapy. A threshold MTR value of 0.3 was identified, above which the risk of local recurrence was low. CONCLUSION: The ratio of margin to tumor thickness was an independent predictor for local recurrence and disease specific death in this cohort. A MTR>0.3 can serve as a useful tool for adjuvant therapy planning as it combines tumor thickness and margin clearance, two well established prognostic factors. The minimum safe margin can be calculated by multiplying the tumor thickness by 0.3. Further prospective studies in other institutions are warranted to confirm the prognostic utility of MTR and assess the generalizability of our threshold values. |
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Copyright © 2016 Elsevier Ltd. All rights reserved. |
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KEYWORDS: Margin, OSCC, Prognostic marker, Thickness |
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Publikations ID: 26861256 Quelle: öffnen |
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