Stratification of surgical margin distances by the millimeter on local recurrence in oral cavity cancer: A systematic review and meta-analysis

Head Neck. 2023 May;45(5):1305-1314. doi: 10.1002/hed.27339. Epub 2023 Mar 9.

Abstract

There are limited data supporting the commonly suggested 5 mm margin cutoff as the optimum value in defining clear margins in oral cancer. A database search of Pubmed/Medline, Web of Science, and EBSCOhost was performed from inception to June 2022. A random-effects model was chosen for this meta-analysis. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed throughout this study. Seven studies met study criteria (2215 patients). The risk ratio was significantly higher for margins <5 mm when compared to those ≥5 mm (2.09 (95%CI: 1.53-2.86, I2 = 0.47)). Subgroup analysis (I2 = 0.15) of margin distances of 0.0-0.9, 1.0-1.9, 2.0-2.9, 3.0-3.9, and 4.0-4.9 mm calculated risk ratios for local recurrence of 2.96, 2.01, 2.17, 1.8, and 0.98, respectively. Margins between 4.0 and 4.9 mm had similar risk ratios for local recurrence compared to ≥5 mm, while margins <4.0 were significantly higher.

Keywords: head and neck surgery; local recurrence; oral cancer; oral squamous cell carcinoma; surgical margin.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Carcinoma, Squamous Cell* / surgery
  • Humans
  • Margins of Excision
  • Mouth Neoplasms* / surgery
  • Neoplasm Recurrence, Local