Margins and survival in oral cancer

Br J Oral Maxillofac Surg. 2018 Nov;56(9):820-829. doi: 10.1016/j.bjoms.2018.06.021. Epub 2018 Sep 13.

Abstract

In the surgical management of oral squamous cell carcinoma (SCC) we aim to resect the tumour with clear margins in all planes. The aim of this study was to identify and compare overall survival in a group of 591 patients who had resections, and to relate this to the clearance of margins at the tumour bed. We used life tables to calculate survival at one, two, three, five, and 10 years after diagnosis by margin (clear=5mm or more; close=2-5mm; and involved=less than 2mm). Kaplan-Meier curves were produced for the margins alone, which were defined as clear in 480 patients (81%), close in 63 (11%), and involved in 48 (8%). Five-year survival was 81%, 75%, and 54% for clear, close, and involved margins, respectively, which highlights the importance of clear margins for survival. There is a significant prognostic implication associated with close, and particularly with involved, margins.

Keywords: Oral cancer; margins; oral squamous cell carcinoma; reconstruction; surgery; survival.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Female
  • Humans
  • Life Tables
  • Male
  • Margins of Excision*
  • Middle Aged
  • Mouth Neoplasms / mortality
  • Mouth Neoplasms / surgery*
  • Neoplasm Staging
  • Prognosis
  • Survival Rate