Impact of histological Oral Tongue Cancer margins on locoregional recurrence: A multi-centre retrospective analysis

James Daniell; Cristian Udovicich; David Rowe; Lachlan McDowell; Domenic Vital; Mathias Bressel; Matthew J R Magarey; Tim A Iseli; Tim Wong; Ernest Lekgabe; Karda Cavanagh; Tsien Fua; Danny Rischin; David Wiesenfeld

doi:10.1016/j.oraloncology.2020.105004

Impact of histological Oral Tongue Cancer margins on locoregional recurrence: A multi-centre retrospective analysis

Oral Oncol. 2020 Dec:111:105004. doi: 10.1016/j.oraloncology.2020.105004. Epub 2020 Oct 7.

Authors

Affiliations

¹ Head and Neck Oncology Tumour Stream, Department of Surgery, The Royal Melbourne Hospital, The University of Melbourne, 300 Grattan Street, Parkville, Victoria, Australia. Electronic address: james.daniell@mh.org.au.
² Department of Radiation Oncology, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria, Australia.
³ Head and Neck Oncology Tumour Stream, Department of Surgery, The Royal Melbourne Hospital, The University of Melbourne, 300 Grattan Street, Parkville, Victoria, Australia.
⁴ Centre for Biostatistics and Clinical Trials (BaCT), Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria, Australia.
⁵ Department of Surgical Oncology, Head and Neck Surgery, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria, Australia; Department of Medical Education, The University of Melbourne, Parkville, Victoria, Australia.
⁶ Department of Radiology, The Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria, Australia.
⁷ Department of Diagnostic Imaging, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria, Australia.
⁸ Department of Medical Oncology, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria, Australia.

PMID: 33038750
DOI: 10.1016/j.oraloncology.2020.105004

Abstract

Objectives: To assess the effect of the histological margins (HM) upon locoregional failure (LRF) and overall survival (OS) for oral tongue squamous cell carcinoma (OTSCC).

Materials and methods: We undertook a retrospective review of 258 patients, across two institutions, treated for OTSCC between 2007 and 2016. A Cox-proportional hazards model was used to compare the relative hazard ratio of HM to the accepted standard of 5 mm margins for LRF and OS.

Results: The median follow up period was 4.8 years. The 5 year OS and freedom from LRF were 69% and 75% respectively. The Cox-proportional hazards model adjusted for age, DOI and LVI showed increasing risk of mortality and LRF with decreasing HM widths of <5 mm.

Conclusion: HM >5 mm were associated with a risk reduction of both LRF and mortality in OTSCC. This study supports >5 mm HM being the oncologic goal of surgery.

Keywords: Margins; Oral cancer; Recurrence; Squamous cell carcinoma; Surgery; Survival; Tongue.

Publication types

Multicenter Study

MeSH terms

Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Male
Margins of Excision*
Middle Aged
Neoplasm Recurrence, Local* / mortality
Neoplasm Staging
Proportional Hazards Models
Radiotherapy, Adjuvant
Retrospective Studies
Squamous Cell Carcinoma of Head and Neck / mortality
Squamous Cell Carcinoma of Head and Neck / pathology*
Squamous Cell Carcinoma of Head and Neck / radiotherapy
Squamous Cell Carcinoma of Head and Neck / surgery
Time Factors
Tongue Neoplasms / mortality
Tongue Neoplasms / pathology*
Tongue Neoplasms / radiotherapy
Tongue Neoplasms / surgery
Young Adult