Kang Chung-Jan, Wen Yu-Wen, Lee Shu-Ru, Lee Li-Yu, Hsueh Chuen, Lin Chien-Yu, Fan Kang-Hsing, Wang Hung-Ming, Hsieh Chia-Hsun, Ng Shu-Hang, Yeh Chih-Hua, Lin Chih-Hung, Tsao Chung-Kan, Fang Tuan-Jen, Huang Shiang-Fu, Lee Li-Ang, Fang Ku-Hao, Yen Tzu-Chen, Cheng Nai-Ming, Tsai Tsung-You, Tai Shiao-Fwu, Tsai Chi-Ying
Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan 333, Taiwan.
Clinical Informatics and Medical Statistics Research Center, Medical College of Chang Gung University, Taoyuan 333, Taiwan.
Cancers (Basel). 2021 Dec 21;14(1):15. doi: 10.3390/cancers14010015.
(1) Background: The optimal cutoff value that maximizes the prognostic value of surgical margins in patients with resected oral cavity squamous cell carcinoma has not yet been identified. (2) Methods: Data for this study were retrieved from the Taiwan Cancer Registry Database. A total of 13,768 Taiwanese patients with oral cavity squamous cell carcinoma were identified and stratified according to different margin statuses (0, 0.1-4 and > 4 mm). The five-year local control, disease-specific survival and overall survival rates were the main outcome measures. (3) Results: The 5-year local control, disease-specific survival and overall survival rates of patients with close margins (0 and 0.1-4 mm) were significantly lower than those observed in patients with clear margins (> 4 mm; all values < 0.001). In multivariate analysis, margin status, depth of invasion and extra-nodal extension were identified as independent adverse prognostic factors for 5-year local control. (4) Conclusions: A thorough assessment of surgical margins can provide a reliable prognostic prediction in patients with OCSCC. This has potential implications for treatment approaches tailored to the individual level. The achievement of clear margins (>4 mm) should be considered a key surgical goal to improve outcomes in this patient group.
(1) 背景：在接受手术切除的口腔鳞状细胞癌患者中，能使手术切缘预后价值最大化的最佳临界值尚未确定。(2) 方法：本研究数据取自台湾癌症登记数据库。共识别出13768例台湾口腔鳞状细胞癌患者，并根据不同切缘状态（0、0.1 - 4和>4 mm）进行分层。主要观察指标为五年局部控制率、疾病特异性生存率和总生存率。(3) 结果：切缘接近（0和0.1 - 4 mm）患者的5年局部控制率、疾病特异性生存率和总生存率显著低于切缘阴性（>4 mm；所有P值<0.001）的患者。多因素分析中，切缘状态、浸润深度和结外扩展被确定为5年局部控制的独立不良预后因素。(4) 结论：对手术切缘进行全面评估可为口腔鳞状细胞癌患者提供可靠的预后预测。这对个体化治疗方案具有潜在意义。实现切缘阴性（>4 mm）应被视为改善该患者群体预后的关键手术目标。
