Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
School of Medicine, National Defense Medical Center, Taipei, Taiwan.
Clin Otolaryngol. 2019 Jan;44(1):63-69. doi: 10.1111/coa.13237. Epub 2018 Oct 25.
We examined whether dynamic margin criteria margin-to-thickness (MTR) ratio has superior predictive value compared with the resection margin or tumour thickness alone in the survival outcome in oral squamous cell carcinoma (OSCC).
This is a retrospective cohort study.
Oral squamous cell carcinoma patients treated in Kaohsiung Veterans General Hospital Cancer Center between January 2006 and December 2013.
A cohort of 302 patients with OSCC who had undergone surgical management.
Log MTR was calculated for each patient, and survival data were analysed using a multivariable Cox regression model. Discriminative analysis was performed using chi-square, Akaike information criterion (AIC) and Harrell's C tests.
After assessing for discriminative ability, the linear trend of log MTR surpassed those of resection margin and tumour thickness in chi-square, AIC and Harrell's C tests for the advanced pathologic T (pT) category. A multivariate Cox proportional hazard regression model revealed that log MTR <33% was associated with less favourable 5-year disease-specific survival (DSS) (P = 0.006) in the entire oral cancer study cohort. Other significant factors included perineural invasion (P = 0.021), pT category, (P = 0.005), pathologic N category (P < 0.001) and differentiation category (P = 0.022).
Log MTR < 33% may be a predictor of less favourable outcome in the DSS of OSCC. Log MTR outperformed both resection margin and tumour thickness alone in terms of discriminative analysis. Our study could help in presurgical planning for high-risk patients and in aiding the decision-making process for adjuvant treatment.
我们研究了在口腔鳞状细胞癌（OSCC）中，与单独的切缘或肿瘤厚度相比，动态边界标准切缘厚度比（MTR）是否具有更好的预测生存结局的价值。
这是一项回顾性队列研究。
高雄荣民总医院癌症中心 2006 年 1 月至 2013 年 12 月期间接受手术治疗的口腔鳞状细胞癌患者。
302 例接受手术治疗的 OSCC 患者。
为每位患者计算对数 MTR，使用多变量 Cox 回归模型分析生存数据。使用卡方检验、赤池信息量准则（AIC）和哈雷尔 C 检验进行判别分析。
在评估判别能力后，对数 MTR 的线性趋势在卡方检验、AIC 和哈雷尔 C 检验中超过了切缘和肿瘤厚度，用于高级病理 T（pT）类别。多变量 Cox 比例风险回归模型显示，对数 MTR<33%与整个口腔癌研究队列中较差的 5 年疾病特异性生存率（DSS）相关（P=0.006）。其他显著因素包括神经周围侵犯（P=0.021）、pT 类别（P=0.005）、病理 N 类别（P<0.001）和分化类别（P=0.022）。
对数 MTR<33%可能是 OSCC 中 DSS 预后不良的预测指标。对数 MTR 在判别分析方面优于单独的切缘和肿瘤厚度。我们的研究可以帮助高风险患者的术前规划，并为辅助治疗的决策过程提供帮助。
