Head and Neck Tumour Stream, Department of Surgery, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia; Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.
Head and Neck Tumour Stream, Department of Surgery, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.
Int J Oral Maxillofac Surg. 2023 Jan;52(1):19-25. doi: 10.1016/j.ijom.2022.04.008. Epub 2022 May 21.
The purpose of this study was to assess the impact of a change in macroscopic/surgical margin width upon histological margins and loco-regional failure in early oral tongue squamous cell carcinoma (OTSCC). In 2009, the surgical margin protocol was increased from 10 mm to 15 mm. A retrospective review was performed of all patients who underwent treatment for early OTSCC between 2009 and 2016 with a 15-mm surgical margin (n = 142), and these patients were compared to those treated between 1999 and 2008 with a 10-mm surgical margin (n = 78). There was a significant increase in the rate of clear histological margins (P < 0.001). The rates of close (P = 0.002) and involved (P < 0.001) histological margins decreased significantly. There were significant reductions in local (P < 0.001) and regional (P < 0.001) recurrence rates. This study demonstrated that a surgical margin of 15 mm delivered significantly lower rates of close/involved histological margins and improved local and regional disease recurrence in early OTSCC when compared with a surgical margin of 10 mm.
本研究旨在评估宏观/手术切缘宽度的变化对早期口腔舌鳞状细胞癌（OTSCC）的组织学切缘和局部区域失败的影响。2009 年，手术切缘方案从 10mm 增加到 15mm。回顾性分析了 2009 年至 2016 年间所有接受 15mm 手术切缘治疗的早期 OTSCC 患者（n=142），并将这些患者与 1999 年至 2008 年间接受 10mm 手术切缘治疗的患者（n=78）进行比较。清晰的组织学切缘率显著增加（P<0.001）。接近（P=0.002）和累及（P<0.001）组织学切缘的比率显著降低。局部（P<0.001）和区域（P<0.001）复发率显著降低。本研究表明，与 10mm 手术切缘相比，15mm 手术切缘可显著降低接近/累及组织学切缘的比率，并改善早期 OTSCC 的局部和区域疾病复发。
