The impact of worst pattern of invasion on the extension of surgical margins in oral squamous cell carcinoma

Head Neck. 2022 Mar;44(3):691-697. doi: 10.1002/hed.26956. Epub 2021 Dec 14.

Abstract

Background: To evaluate margins for oral carcinoma according to types of invasion front.

Methods: Retrospective cohort of 772 patients with worst pattern of invasion (WPOI) graded 1-5. Local recurrence was the outcome of interest.

Results: Local recurrences occurred in 164 patients (21.2%) and was affected by WPOI type 4/5, margin distance, perineural invasion, and adjuvant radiotherapy. In patients with WPOI types 1/2/3, a cutoff of 1.7 mm was considered ideal margin extent and in patients with WPOI types 4/5, the cutoff was 7.8 mm. Patients below these thresholds had a significantly higher incidence of local recurrence.

Conclusions: Different WPOI determine the ideal extent of surgical margins as 1.7 mm for patients with types 1-3, and 7.8 mm in patients with types 4/5.

Keywords: margins of excision; mouth neoplasms; neoplasm recurrence; pathology; surgery.

MeSH terms

  • Carcinoma, Squamous Cell* / pathology
  • Carcinoma, Squamous Cell* / surgery
  • Head and Neck Neoplasms* / pathology
  • Humans
  • Margins of Excision
  • Mouth Neoplasms* / pathology
  • Mouth Neoplasms* / surgery
  • Neoplasm Invasiveness / pathology
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck / pathology