Margin Sampling and Survival Outcomes in Oral Cavity and p16-Positive Oropharyngeal Squamous Cell Carcinoma

Colin MacKay; Brooke Turner; Martin Bullock; S Mark Taylor; Jonathan Trites; Martin Corsten; Laurette Geldenhuys; Matthew H Rigby

doi:10.1177/2473974X221101024

Margin Sampling and Survival Outcomes in Oral Cavity and p16-Positive Oropharyngeal Squamous Cell Carcinoma

OTO Open. 2022 Sep 21;6(3):2473974X221101024. doi: 10.1177/2473974X221101024. eCollection 2022 Jul-Sep.

Authors

Colin MacKay¹, Brooke Turner¹, Martin Bullock², S Mark Taylor¹, Jonathan Trites¹, Martin Corsten¹, Laurette Geldenhuys², Matthew H Rigby¹

Affiliations

¹ Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Queen Elizabeth II Health Science Centre and Dalhousie University, Halifax, Canada.
² Division of Anatomical Pathology, Department of Pathology, Queen Elizabeth II Health Science Centre and Dalhousie University, Halifax, Canada.

Abstract

Objective: To compare the association of margin sampling technique on survival outcomes in surgically treated cT1-2 oral cavity and oropharyngeal squamous cell carcinoma.

Study design: A prospective longitudinal cohort study.

Setting: Tertiary care academic teaching hospital in Halifax, Nova Scotia.

Methods: All cases of surgically treated cT1-2 oral cavity and oropharyngeal cancer undergoing specimen-oriented margin analysis between January 1, 2017, and December 31, 2018 were analyzed. The specimen-oriented cohort was compared with a cohort of patients from January 1, 2009, to December 31, 2014, where a defect-oriented margin sampling protocol was used. Kaplan-Meier survival curves were used to estimate 2-year overall survival, disease-specific survival, local control, and recurrence-free survival rates in oral cavity and p16-positive oropharyngeal squamous cell carcinoma. Cox proportional hazards models were used to assess the effect of margin sampling method on disease-specific survival and local control.

Results: There was no significant association between margin sampling technique and 2-year survival outcomes for surgically treated cT1-2 oral cavity and oropharyngeal squamous cell carcinoma. In the multivariate Cox proportional hazard model, the hazard ratio (HR) of specimen-oriented sampling was not significantly different for disease-specific survival (HR, 1.32; 95% CI, 0.3032-5.727; P = .713) or local control (HR, 0.4087; 95% CI, 0.0795-2.099; P = .284).

Conclusion: Intraoperative margin sampling method was not associated with a significant change in 2-year survival outcomes. Despite no effect on survival outcomes, implementation of a specimen-oriented sampling method has potential for cost avoidance by decreasing the number of re-resections for positive or close margins.

Keywords: oral cavity; oropharynx; specimen oriented; squamous cell carcinoma; survival outcomes.