Gokavarapu Sandhya, Chander Ravi, Parvataneni Nagendra, Puthamakula Sreenivasa
Basavatarakam Indo American Cancer Hospital and Research Centre, Hyderabad, Andhra Pradesh 500034, India.
Seven Hills Hospital, Andheri West, Mumbai, India.
Int J Surg Oncol. 2014;2014:545372. doi: 10.1155/2014/545372. Epub 2014 Nov 11.
Among all prognostic factors, "margin status" is the only factor under clinician's control. Current guidelines describe histopathologic margin of >5 mm as "clear margin" and 1-5 mm as "close margin." Ambiguous description of positive margin in the published data resulted in comparison of microscopically "involved margin" and "close margin" together with "clear margin" in many publications. Authors attempted to compare the outcome of close and clear margins of stage I and stage II squamous cell carcinoma of oral cavity to investigate the efficacy of description of margin status.
Historical cohorts of patients treated between January 2010 and December 2011 at tertiary cancer hospital were investigated and filtered for stage I and stage II primary squamous cell carcinomas of oral cavity. Patients with margin status of tumor at margin or within 1mm from cut margin were excluded and analyzed in multivariate logistic regression model for locoregional recurrences and Cox regression for overall survival.
A total of 104 patients fulfilled the abovementioned criteria, of whom 36 were "clear margin" and 68 were "close margin" with median period of follow-up of 39 months. There was no significant difference in locoregional recurrence (P value: 0.0.810) and survival (P value: 0.0.851) among "close margin" and "clear margin" patients.
在所有预后因素中,“切缘状态”是临床医生唯一能够控制的因素。当前指南将组织病理学切缘>5毫米描述为“切缘阴性”,1 - 5毫米为“切缘阳性”。已发表数据中对阳性切缘的描述不明确,导致许多出版物将显微镜下“浸润性切缘”和“切缘阳性”与“切缘阴性”一同进行比较。作者试图比较口腔I期和II期鳞状细胞癌切缘阳性和阴性的预后,以研究切缘状态描述的有效性。
对2010年1月至2011年12月在三级癌症医院接受治疗的患者历史队列进行调查,并筛选出I期和II期原发性口腔鳞状细胞癌患者。排除肿瘤切缘状态为切缘或距切缘1毫米以内的患者,并对局部区域复发进行多因素逻辑回归分析,对总生存期进行Cox回归分析。
共有104例患者符合上述标准,其中36例为“切缘阴性”,68例为“切缘阳性”,中位随访期为39个月。“切缘阳性”和“切缘阴性”患者在局部区域复发(P值:0.810)和生存率(P值:0.851)方面无显著差异。