Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Department of Otolaryngology-Head and Neck Surgery, University Health Network, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
Head Neck. 2022 Feb;44(2):453-459. doi: 10.1002/hed.26943. Epub 2021 Nov 29.
Masticator space involvement in oral cavity squamous cell carcinoma (OCSCC) is considered an unresectable disease. Nevertheless, achieving negative resection margins is feasible in limited masticatory space involvement.
A multi-institutional study on OCSCC patients with masticator space invasion who underwent surgical resection. Margin status was assessed according to anatomic tumor involvement of the inframandibular and supra-mandibular notch.
One-hundred and thirty-two patients met the inclusion criteria. Then, 67 patients (50.8%) were diagnosed with a supra-notch tumor and 65 (49.2%) with an infra-notch disease. Negative margins were more common in the infra-notch group (43.3 vs. 23.1%, p = 0.014), and positive margins were more common in the supra-notch group (41.5 vs. 23.9%, p = 0.041). Multivariable analysis demonstrated that supra-notch tumors had an increased likelihood for involved resection margins (odds ratio = 2.46, p = 0.036).
OCSCC patients with masticator space involvement are prone for positive surgical margins in tumors extending above the supra-mandibular notch.
咀嚼肌间隙累及口腔鳞状细胞癌（OCSCC）被认为是不可切除的疾病。然而，在咀嚼肌间隙受累有限的情况下，实现阴性切缘是可行的。
对接受手术切除的咀嚼肌间隙侵犯的 OCSCC 患者进行多机构研究。根据下颌下和上颌切迹的解剖肿瘤累及情况评估切缘状态。
132 名患者符合纳入标准。然后，67 名患者（50.8%）被诊断为上颌切迹肿瘤，65 名患者（49.2%）为下颌切迹疾病。下颌切迹组的阴性切缘更为常见（43.3%比 23.1%，p=0.014），而上颌切迹组的阳性切缘更为常见（41.5%比 23.9%，p=0.041）。多变量分析表明，上颌切迹肿瘤的阳性切缘更有可能受累（优势比=2.46，p=0.036）。
咀嚼肌间隙受累的 OCSCC 患者在上颌切迹上方的肿瘤中更容易出现阳性手术切缘。
