Differential Impact of Close Surgical Margin on Local Recurrence According to Primary Tumor Size in Oral Squamous Cell Carcinoma
Background The extent of surgical safety margin (gross tumor border to resection margin) in oral cancer surgery remains unclear, and no study has determined the differential impact of close surgical margin and microscopic extension according to primary tumor size in oral cancers. Methods We retrospe...
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| Veröffentlicht in: | Annals of surgical oncology 2017-06, Vol.24 (6), p.1698-1706 |
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| container_title | Annals of surgical oncology |
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| creator | Jang, Jeon Yeob Choi, Nayeon Ko, Young-Hyeh Chung, Man Ki Son, Young-Ik Baek, Chung-Hwan Baek, Kwan-Hyuck Jeong, Han-Sin |
| description | Background
The extent of surgical safety margin (gross tumor border to resection margin) in oral cancer surgery remains unclear, and no study has determined the differential impact of close surgical margin and microscopic extension according to primary tumor size in oral cancers.
Methods
We retrospectively analyzed the clinical data of 325 patients with surgically treated oral cavity squamous cell carcinomas to determine the effect of a close surgical margin ( |
| doi_str_mv | 10.1245/s10434-016-5497-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1859714785</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1899622378</sourcerecordid><originalsourceid>FETCH-LOGICAL-c438t-dbeea81c7d97efcae03771e84be6ac2fe4360f1aae303af18bd559dd105b54103</originalsourceid><addsrcrecordid>eNp1kUFv1DAQha0K1JbSH8AFWeLCJeCJ7dg5VmmBSouK2HK2HGe8SpXEWzs5lBM_Ha9SUFWpJ48933sz1iPkHbBPUAr5OQETXBQMqkKKWhXiiJyCzC-i0vAq16zSRV1W8oS8SemOMVCcyWNyUioJNZflKflz2XuPEae5twO9HvfWzTR42gwhId0ucde73PhuczHRMNFNONx_oltiVjmkF86F2PXTjs6B_oj9aOMDvV3GEOm2_400y25ilmzvFzuGJdEGh4E2Nrp-CqN9S157OyQ8fzzPyK8vV7fNt2Jz8_W6udgUTnA9F12LaDU41dUKvbPIuFKAWrRYWVd6FLxiHqxFzrj1oNtOyrrrgMlWCmD8jHxcffcx3C-YZjP2yeVV7IR5KwNa1gqE0jKjH56hd2GJU94uU3VdlSVXOlOwUi6GlCJ6s18_b4CZQzxmjcfkeMwhHiOy5v2j89KO2P1X_MsjA-UKpNyadhifjH7R9S-XbZuE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1899622378</pqid></control><display><type>article</type><title>Differential Impact of Close Surgical Margin on Local Recurrence According to Primary Tumor Size in Oral Squamous Cell Carcinoma</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Jang, Jeon Yeob ; Choi, Nayeon ; Ko, Young-Hyeh ; Chung, Man Ki ; Son, Young-Ik ; Baek, Chung-Hwan ; Baek, Kwan-Hyuck ; Jeong, Han-Sin</creator><creatorcontrib>Jang, Jeon Yeob ; Choi, Nayeon ; Ko, Young-Hyeh ; Chung, Man Ki ; Son, Young-Ik ; Baek, Chung-Hwan ; Baek, Kwan-Hyuck ; Jeong, Han-Sin</creatorcontrib><description>Background
The extent of surgical safety margin (gross tumor border to resection margin) in oral cancer surgery remains unclear, and no study has determined the differential impact of close surgical margin and microscopic extension according to primary tumor size in oral cancers.
Methods
We retrospectively analyzed the clinical data of 325 patients with surgically treated oral cavity squamous cell carcinomas to determine the effect of a close surgical margin (<5 mm) (cSM
5
) on local recurrence. In addition, the depth of microscopic tumor infiltration was determined in 90 available surgical specimens.
Results
The cSM
5
was not related to the risk of local tumor recurrence in early-stage oral cancer, while it significantly increased the rate of local tumor recurrence in resectable advanced-stage oral cancers (hazard ratio 3.157, 95 % confidence interval 1.050–9.407,
p
= 0.041). Addition of postoperative adjuvant radiation to early-stage tumors with cSM
5
did not further reduce the local recurrence rate compared to surgery alone. The depth of microscopic tumor extension from the gross tumor border was significantly associated with primary tumor thickness (
ρ
= 0.390,
p
< 0.001) and tumor sizes (
ρ
= 0.308,
p
= 0.003), which was a median (range) of 0.84 (0.14–2.32) mm in T1, 1.06 (0.20–4.34) mm in T2, and 1.77 (0.13–4.70) mm in T3–4.
Conclusions
The cSM
5
was a significant risk factor for local recurrence only in advanced oral cancers, but not in early-stage tumors, where microscopic tumor extension was not beyond 3 mm in T1 tumors. Thus, the extent of surgical safety margin can be redefined according to the primary tumor size.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-016-5497-4</identifier><identifier>PMID: 27519352</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Carcinoma, Squamous Cell - pathology ; Carcinoma, Squamous Cell - surgery ; Cell size ; Data processing ; Female ; Follow-Up Studies ; Head and Neck Oncology ; Humans ; Lymphatic Metastasis ; Male ; Medicine ; Medicine & Public Health ; Metastases ; Mouth Neoplasms - pathology ; Mouth Neoplasms - surgery ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local - pathology ; Neoplasm Recurrence, Local - surgery ; Neoplasm, Residual - pathology ; Neoplasm, Residual - surgery ; Oncology ; Oral cancer ; Oral carcinoma ; Oral cavity ; Oral squamous cell carcinoma ; Prognosis ; Retrospective Studies ; Squamous cell carcinoma ; Surgery ; Surgical Oncology ; Survival Rate ; Tumors</subject><ispartof>Annals of surgical oncology, 2017-06, Vol.24 (6), p.1698-1706</ispartof><rights>Society of Surgical Oncology 2016</rights><rights>Annals of Surgical Oncology is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-dbeea81c7d97efcae03771e84be6ac2fe4360f1aae303af18bd559dd105b54103</citedby><cites>FETCH-LOGICAL-c438t-dbeea81c7d97efcae03771e84be6ac2fe4360f1aae303af18bd559dd105b54103</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-016-5497-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-016-5497-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27519352$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jang, Jeon Yeob</creatorcontrib><creatorcontrib>Choi, Nayeon</creatorcontrib><creatorcontrib>Ko, Young-Hyeh</creatorcontrib><creatorcontrib>Chung, Man Ki</creatorcontrib><creatorcontrib>Son, Young-Ik</creatorcontrib><creatorcontrib>Baek, Chung-Hwan</creatorcontrib><creatorcontrib>Baek, Kwan-Hyuck</creatorcontrib><creatorcontrib>Jeong, Han-Sin</creatorcontrib><title>Differential Impact of Close Surgical Margin on Local Recurrence According to Primary Tumor Size in Oral Squamous Cell Carcinoma</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
The extent of surgical safety margin (gross tumor border to resection margin) in oral cancer surgery remains unclear, and no study has determined the differential impact of close surgical margin and microscopic extension according to primary tumor size in oral cancers.
Methods
We retrospectively analyzed the clinical data of 325 patients with surgically treated oral cavity squamous cell carcinomas to determine the effect of a close surgical margin (<5 mm) (cSM
5
) on local recurrence. In addition, the depth of microscopic tumor infiltration was determined in 90 available surgical specimens.
Results
The cSM
5
was not related to the risk of local tumor recurrence in early-stage oral cancer, while it significantly increased the rate of local tumor recurrence in resectable advanced-stage oral cancers (hazard ratio 3.157, 95 % confidence interval 1.050–9.407,
p
= 0.041). Addition of postoperative adjuvant radiation to early-stage tumors with cSM
5
did not further reduce the local recurrence rate compared to surgery alone. The depth of microscopic tumor extension from the gross tumor border was significantly associated with primary tumor thickness (
ρ
= 0.390,
p
< 0.001) and tumor sizes (
ρ
= 0.308,
p
= 0.003), which was a median (range) of 0.84 (0.14–2.32) mm in T1, 1.06 (0.20–4.34) mm in T2, and 1.77 (0.13–4.70) mm in T3–4.
Conclusions
The cSM
5
was a significant risk factor for local recurrence only in advanced oral cancers, but not in early-stage tumors, where microscopic tumor extension was not beyond 3 mm in T1 tumors. Thus, the extent of surgical safety margin can be redefined according to the primary tumor size.</description><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Carcinoma, Squamous Cell - surgery</subject><subject>Cell size</subject><subject>Data processing</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Head and Neck Oncology</subject><subject>Humans</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Mouth Neoplasms - pathology</subject><subject>Mouth Neoplasms - surgery</subject><subject>Neoplasm Invasiveness</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>Neoplasm, Residual - pathology</subject><subject>Neoplasm, Residual - surgery</subject><subject>Oncology</subject><subject>Oral cancer</subject><subject>Oral carcinoma</subject><subject>Oral cavity</subject><subject>Oral squamous cell carcinoma</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Squamous cell carcinoma</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival Rate</subject><subject>Tumors</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kUFv1DAQha0K1JbSH8AFWeLCJeCJ7dg5VmmBSouK2HK2HGe8SpXEWzs5lBM_Ha9SUFWpJ48933sz1iPkHbBPUAr5OQETXBQMqkKKWhXiiJyCzC-i0vAq16zSRV1W8oS8SemOMVCcyWNyUioJNZflKflz2XuPEae5twO9HvfWzTR42gwhId0ucde73PhuczHRMNFNONx_oltiVjmkF86F2PXTjs6B_oj9aOMDvV3GEOm2_400y25ilmzvFzuGJdEGh4E2Nrp-CqN9S157OyQ8fzzPyK8vV7fNt2Jz8_W6udgUTnA9F12LaDU41dUKvbPIuFKAWrRYWVd6FLxiHqxFzrj1oNtOyrrrgMlWCmD8jHxcffcx3C-YZjP2yeVV7IR5KwNa1gqE0jKjH56hd2GJU94uU3VdlSVXOlOwUi6GlCJ6s18_b4CZQzxmjcfkeMwhHiOy5v2j89KO2P1X_MsjA-UKpNyadhifjH7R9S-XbZuE</recordid><startdate>20170601</startdate><enddate>20170601</enddate><creator>Jang, Jeon Yeob</creator><creator>Choi, Nayeon</creator><creator>Ko, Young-Hyeh</creator><creator>Chung, Man Ki</creator><creator>Son, Young-Ik</creator><creator>Baek, Chung-Hwan</creator><creator>Baek, Kwan-Hyuck</creator><creator>Jeong, Han-Sin</creator><general>Springer International Publishing</general><general>Springer Nature B.V</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>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20170601</creationdate><title>Differential Impact of Close Surgical Margin on Local Recurrence According to Primary Tumor Size in Oral Squamous Cell Carcinoma</title><author>Jang, Jeon Yeob ; Choi, Nayeon ; Ko, Young-Hyeh ; Chung, Man Ki ; Son, Young-Ik ; Baek, Chung-Hwan ; Baek, Kwan-Hyuck ; Jeong, Han-Sin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-dbeea81c7d97efcae03771e84be6ac2fe4360f1aae303af18bd559dd105b54103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Carcinoma, Squamous Cell - pathology</topic><topic>Carcinoma, Squamous Cell - surgery</topic><topic>Cell size</topic><topic>Data processing</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Head and Neck Oncology</topic><topic>Humans</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Mouth Neoplasms - pathology</topic><topic>Mouth Neoplasms - surgery</topic><topic>Neoplasm Invasiveness</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Recurrence, Local - surgery</topic><topic>Neoplasm, Residual - pathology</topic><topic>Neoplasm, Residual - surgery</topic><topic>Oncology</topic><topic>Oral cancer</topic><topic>Oral carcinoma</topic><topic>Oral cavity</topic><topic>Oral squamous cell carcinoma</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Squamous cell carcinoma</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival Rate</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jang, Jeon Yeob</creatorcontrib><creatorcontrib>Choi, Nayeon</creatorcontrib><creatorcontrib>Ko, Young-Hyeh</creatorcontrib><creatorcontrib>Chung, Man Ki</creatorcontrib><creatorcontrib>Son, Young-Ik</creatorcontrib><creatorcontrib>Baek, Chung-Hwan</creatorcontrib><creatorcontrib>Baek, Kwan-Hyuck</creatorcontrib><creatorcontrib>Jeong, Han-Sin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jang, Jeon Yeob</au><au>Choi, Nayeon</au><au>Ko, Young-Hyeh</au><au>Chung, Man Ki</au><au>Son, Young-Ik</au><au>Baek, Chung-Hwan</au><au>Baek, Kwan-Hyuck</au><au>Jeong, Han-Sin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Differential Impact of Close Surgical Margin on Local Recurrence According to Primary Tumor Size in Oral Squamous Cell Carcinoma</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2017-06-01</date><risdate>2017</risdate><volume>24</volume><issue>6</issue><spage>1698</spage><epage>1706</epage><pages>1698-1706</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
The extent of surgical safety margin (gross tumor border to resection margin) in oral cancer surgery remains unclear, and no study has determined the differential impact of close surgical margin and microscopic extension according to primary tumor size in oral cancers.
Methods
We retrospectively analyzed the clinical data of 325 patients with surgically treated oral cavity squamous cell carcinomas to determine the effect of a close surgical margin (<5 mm) (cSM
5
) on local recurrence. In addition, the depth of microscopic tumor infiltration was determined in 90 available surgical specimens.
Results
The cSM
5
was not related to the risk of local tumor recurrence in early-stage oral cancer, while it significantly increased the rate of local tumor recurrence in resectable advanced-stage oral cancers (hazard ratio 3.157, 95 % confidence interval 1.050–9.407,
p
= 0.041). Addition of postoperative adjuvant radiation to early-stage tumors with cSM
5
did not further reduce the local recurrence rate compared to surgery alone. The depth of microscopic tumor extension from the gross tumor border was significantly associated with primary tumor thickness (
ρ
= 0.390,
p
< 0.001) and tumor sizes (
ρ
= 0.308,
p
= 0.003), which was a median (range) of 0.84 (0.14–2.32) mm in T1, 1.06 (0.20–4.34) mm in T2, and 1.77 (0.13–4.70) mm in T3–4.
Conclusions
The cSM
5
was a significant risk factor for local recurrence only in advanced oral cancers, but not in early-stage tumors, where microscopic tumor extension was not beyond 3 mm in T1 tumors. Thus, the extent of surgical safety margin can be redefined according to the primary tumor size.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>27519352</pmid><doi>10.1245/s10434-016-5497-4</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2017-06, Vol.24 (6), p.1698-1706 |
| issn | 1068-9265 1534-4681 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1859714785 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - surgery Cell size Data processing Female Follow-Up Studies Head and Neck Oncology Humans Lymphatic Metastasis Male Medicine Medicine & Public Health Metastases Mouth Neoplasms - pathology Mouth Neoplasms - surgery Neoplasm Invasiveness Neoplasm Recurrence, Local - pathology Neoplasm Recurrence, Local - surgery Neoplasm, Residual - pathology Neoplasm, Residual - surgery Oncology Oral cancer Oral carcinoma Oral cavity Oral squamous cell carcinoma Prognosis Retrospective Studies Squamous cell carcinoma Surgery Surgical Oncology Survival Rate Tumors |
| title | Differential Impact of Close Surgical Margin on Local Recurrence According to Primary Tumor Size in Oral Squamous Cell Carcinoma |
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