How Does the Close Surgical Margin Impact Recurrence and Survival When Treating Oral Squamous Cell Carcinoma?
Purpose The surgical margin is the main prognostic factor over which the surgeon has control during resection of oral squamous cell carcinoma (OSCC). This study examined the association between surgical excision margins of patients with OSCC and outcomes of disease-free and overall survival. Materia...
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| Veröffentlicht in: | Journal of oral and maxillofacial surgery 2015-06, Vol.73 (6), p.1182-1188 |
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| container_title | Journal of oral and maxillofacial surgery |
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| creator | Dillon, Jasjit K., DDS, MD Brown, Christopher B., DDS McDonald, Tyler M., DDS Ludwig, David C., BA Clark, Patrick J., BA Leroux, Brian G., PhD Futran, Neal D., DMD, MD |
| description | Purpose The surgical margin is the main prognostic factor over which the surgeon has control during resection of oral squamous cell carcinoma (OSCC). This study examined the association between surgical excision margins of patients with OSCC and outcomes of disease-free and overall survival. Materials and Methods The authors implemented a retrospective cohort study. The sample was composed of patients with OSCC having resection as their initial treatment. The predictor variable was the pathologic surgical margin, defined as clear (>5 mm), close (1 to 5 mm), or involved ( |
| doi_str_mv | 10.1016/j.joms.2014.12.014 |
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This study examined the association between surgical excision margins of patients with OSCC and outcomes of disease-free and overall survival. Materials and Methods The authors implemented a retrospective cohort study. The sample was composed of patients with OSCC having resection as their initial treatment. The predictor variable was the pathologic surgical margin, defined as clear (>5 mm), close (1 to 5 mm), or involved (<1 mm). The outcome variables were disease-free (absence of locoregional recurrence) and overall survival. Data were analyzed using Kaplan-Meier survival curves and Cox regression hazard model. Results The sample was composed of 54 patients with a mean age of 60.5 years (range, 19 to 85 yr) and 26% were women. The 2- and 5-year overall survival rates were 59 and 50%, respectively. The clear surgical margin group showed higher disease-free survival rates than patients with close and involved margins (5-yr probability, 0.78 vs 0.43 and 0.29; P = .014) and a trend toward increased overall survival at 2 and 5 years ( P = .093). Conclusion The results suggest that the presence of a close surgical margin (1 to 5 mm) is an adverse risk feature comparable to an involved margin and therefore is associated with decreased disease-free and overall survival. Future studies are needed to replicate these findings before they can be used as a basis for clinical recommendations.</description><identifier>ISSN: 0278-2391</identifier><identifier>EISSN: 1531-5053</identifier><identifier>DOI: 10.1016/j.joms.2014.12.014</identifier><identifier>PMID: 25795179</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell - pathology ; Carcinoma, Squamous Cell - secondary ; Carcinoma, Squamous Cell - surgery ; Chemotherapy, Adjuvant ; Cohort Studies ; Dentistry ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis - pathology ; Male ; Microsurgery - methods ; Middle Aged ; Mouth Neoplasms - pathology ; Mouth Neoplasms - surgery ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local - pathology ; Neoplasm Staging ; Radiotherapy, Adjuvant ; Retrospective Studies ; Surgery ; Survival Rate ; Treatment Outcome ; Young Adult</subject><ispartof>Journal of oral and maxillofacial surgery, 2015-06, Vol.73 (6), p.1182-1188</ispartof><rights>American Association of Oral and Maxillofacial Surgeons</rights><rights>2015 American Association of Oral and Maxillofacial Surgeons</rights><rights>Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c481t-1b36720f598bf244dcb80a80afbccb3438a2bfb21d14d452b30d0869ff2ccca83</citedby><cites>FETCH-LOGICAL-c481t-1b36720f598bf244dcb80a80afbccb3438a2bfb21d14d452b30d0869ff2ccca83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.joms.2014.12.014$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,778,782,3539,27907,27908,45978</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25795179$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dillon, Jasjit K., DDS, MD</creatorcontrib><creatorcontrib>Brown, Christopher B., DDS</creatorcontrib><creatorcontrib>McDonald, Tyler M., DDS</creatorcontrib><creatorcontrib>Ludwig, David C., BA</creatorcontrib><creatorcontrib>Clark, Patrick J., BA</creatorcontrib><creatorcontrib>Leroux, Brian G., PhD</creatorcontrib><creatorcontrib>Futran, Neal D., DMD, MD</creatorcontrib><title>How Does the Close Surgical Margin Impact Recurrence and Survival When Treating Oral Squamous Cell Carcinoma?</title><title>Journal of oral and maxillofacial surgery</title><addtitle>J Oral Maxillofac Surg</addtitle><description>Purpose The surgical margin is the main prognostic factor over which the surgeon has control during resection of oral squamous cell carcinoma (OSCC). This study examined the association between surgical excision margins of patients with OSCC and outcomes of disease-free and overall survival. Materials and Methods The authors implemented a retrospective cohort study. The sample was composed of patients with OSCC having resection as their initial treatment. The predictor variable was the pathologic surgical margin, defined as clear (>5 mm), close (1 to 5 mm), or involved (<1 mm). The outcome variables were disease-free (absence of locoregional recurrence) and overall survival. Data were analyzed using Kaplan-Meier survival curves and Cox regression hazard model. Results The sample was composed of 54 patients with a mean age of 60.5 years (range, 19 to 85 yr) and 26% were women. The 2- and 5-year overall survival rates were 59 and 50%, respectively. The clear surgical margin group showed higher disease-free survival rates than patients with close and involved margins (5-yr probability, 0.78 vs 0.43 and 0.29; P = .014) and a trend toward increased overall survival at 2 and 5 years ( P = .093). Conclusion The results suggest that the presence of a close surgical margin (1 to 5 mm) is an adverse risk feature comparable to an involved margin and therefore is associated with decreased disease-free and overall survival. Future studies are needed to replicate these findings before they can be used as a basis for clinical recommendations.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Carcinoma, Squamous Cell - secondary</subject><subject>Carcinoma, Squamous Cell - surgery</subject><subject>Chemotherapy, Adjuvant</subject><subject>Cohort Studies</subject><subject>Dentistry</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Lymphatic Metastasis - pathology</subject><subject>Male</subject><subject>Microsurgery - methods</subject><subject>Middle Aged</subject><subject>Mouth Neoplasms - pathology</subject><subject>Mouth Neoplasms - surgery</subject><subject>Neoplasm Invasiveness</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Staging</subject><subject>Radiotherapy, Adjuvant</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0278-2391</issn><issn>1531-5053</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9rFTEUxYMo9rX6BVxIlm5mzM1k_oEoMlpbaCn4Ki5DJnOnzTiTvCYzT_rtm-G1XbgQAieEcy43v0PIO2ApMCg-DungppByBiIFnkZ5QTaQZ5DkLM9ekg3jZZXwrIYjchzCwBhAXhavyRHPyzqHst6Q6cz9pd8cBjrfIm1GF5BuF39jtBrppYoXS8-nndIz_Yl68R6tRqpst7r2Zh9dv2_R0muPajb2hl75-LS9W9TklkAbHEfaKK-NdZP68oa86tUY8O2jnpBfp9-vm7Pk4urHefP1ItGigjmBNitKzvq8rtqeC9HptmIqnr7Vus1EVine9i2HDkQnct5mrGNVUfc911qrKjshHw5zd97dLRhmOZmg4y7KYlxLQlFBDaIuymjlB6v2LgSPvdx5Myl_L4HJFbMc5IpZrpglcBklht4_zl_aCbvnyBPXaPh0MGD85d6gl0GbFV1nPOpZds78f_7nf-J6NHbt5A_eYxjc4m3kJ0GGGJDbtei1ZxAMKh7LfwDNBaPB</recordid><startdate>20150601</startdate><enddate>20150601</enddate><creator>Dillon, Jasjit K., DDS, MD</creator><creator>Brown, Christopher B., DDS</creator><creator>McDonald, Tyler M., DDS</creator><creator>Ludwig, David C., BA</creator><creator>Clark, Patrick J., BA</creator><creator>Leroux, Brian G., PhD</creator><creator>Futran, Neal D., DMD, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150601</creationdate><title>How Does the Close Surgical Margin Impact Recurrence and Survival When Treating Oral Squamous Cell Carcinoma?</title><author>Dillon, Jasjit K., DDS, MD ; Brown, Christopher B., DDS ; McDonald, Tyler M., DDS ; Ludwig, David C., BA ; Clark, Patrick J., BA ; Leroux, Brian G., PhD ; Futran, Neal D., DMD, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c481t-1b36720f598bf244dcb80a80afbccb3438a2bfb21d14d452b30d0869ff2ccca83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Carcinoma, Squamous Cell - pathology</topic><topic>Carcinoma, Squamous Cell - secondary</topic><topic>Carcinoma, Squamous Cell - surgery</topic><topic>Chemotherapy, Adjuvant</topic><topic>Cohort Studies</topic><topic>Dentistry</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Lymphatic Metastasis - pathology</topic><topic>Male</topic><topic>Microsurgery - methods</topic><topic>Middle Aged</topic><topic>Mouth Neoplasms - pathology</topic><topic>Mouth Neoplasms - surgery</topic><topic>Neoplasm Invasiveness</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Staging</topic><topic>Radiotherapy, Adjuvant</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dillon, Jasjit K., DDS, MD</creatorcontrib><creatorcontrib>Brown, Christopher B., DDS</creatorcontrib><creatorcontrib>McDonald, Tyler M., DDS</creatorcontrib><creatorcontrib>Ludwig, David C., BA</creatorcontrib><creatorcontrib>Clark, Patrick J., BA</creatorcontrib><creatorcontrib>Leroux, Brian G., PhD</creatorcontrib><creatorcontrib>Futran, Neal D., DMD, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of oral and maxillofacial surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dillon, Jasjit K., DDS, MD</au><au>Brown, Christopher B., DDS</au><au>McDonald, Tyler M., DDS</au><au>Ludwig, David C., BA</au><au>Clark, Patrick J., BA</au><au>Leroux, Brian G., PhD</au><au>Futran, Neal D., DMD, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>How Does the Close Surgical Margin Impact Recurrence and Survival When Treating Oral Squamous Cell Carcinoma?</atitle><jtitle>Journal of oral and maxillofacial surgery</jtitle><addtitle>J Oral Maxillofac Surg</addtitle><date>2015-06-01</date><risdate>2015</risdate><volume>73</volume><issue>6</issue><spage>1182</spage><epage>1188</epage><pages>1182-1188</pages><issn>0278-2391</issn><eissn>1531-5053</eissn><abstract>Purpose The surgical margin is the main prognostic factor over which the surgeon has control during resection of oral squamous cell carcinoma (OSCC). This study examined the association between surgical excision margins of patients with OSCC and outcomes of disease-free and overall survival. Materials and Methods The authors implemented a retrospective cohort study. The sample was composed of patients with OSCC having resection as their initial treatment. The predictor variable was the pathologic surgical margin, defined as clear (>5 mm), close (1 to 5 mm), or involved (<1 mm). The outcome variables were disease-free (absence of locoregional recurrence) and overall survival. Data were analyzed using Kaplan-Meier survival curves and Cox regression hazard model. Results The sample was composed of 54 patients with a mean age of 60.5 years (range, 19 to 85 yr) and 26% were women. The 2- and 5-year overall survival rates were 59 and 50%, respectively. The clear surgical margin group showed higher disease-free survival rates than patients with close and involved margins (5-yr probability, 0.78 vs 0.43 and 0.29; P = .014) and a trend toward increased overall survival at 2 and 5 years ( P = .093). Conclusion The results suggest that the presence of a close surgical margin (1 to 5 mm) is an adverse risk feature comparable to an involved margin and therefore is associated with decreased disease-free and overall survival. Future studies are needed to replicate these findings before they can be used as a basis for clinical recommendations.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25795179</pmid><doi>10.1016/j.joms.2014.12.014</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - secondary Carcinoma, Squamous Cell - surgery Chemotherapy, Adjuvant Cohort Studies Dentistry Disease-Free Survival Female Follow-Up Studies Humans Lymphatic Metastasis - pathology Male Microsurgery - methods Middle Aged Mouth Neoplasms - pathology Mouth Neoplasms - surgery Neoplasm Invasiveness Neoplasm Recurrence, Local - pathology Neoplasm Staging Radiotherapy, Adjuvant Retrospective Studies Surgery Survival Rate Treatment Outcome Young Adult |
| title | How Does the Close Surgical Margin Impact Recurrence and Survival When Treating Oral Squamous Cell Carcinoma? |
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