仔细观察颊黏膜癌的切缘：对局部无复发生存的影响。
A closer look at the resection margins of buccal mucosa cancer: Their influence on local recurrence free survival.
机构信息
Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands.
出版信息
Head Neck. 2023 Apr;45(4):983-992. doi: 10.1002/hed.27322. Epub 2023 Feb 24.
BACKGROUND
The adequate surgical margin for local control of buccal mucosa squamous cell carcinoma (BMSCC) is under debate. This study investigates surgical margins and other factors associated with local recurrence free survival (LRFS) in a large cohort of BMSCC patients.
METHODS
Multiple factors were evaluated retrospectively in 97 patients with BMSCC. Cox-regression and Kaplan-Meier curves were used for analysis.
RESULTS
The local recurrence rate was 23%. The tumor-free margin was <5.0 mm in 89% of the patients and the deep margin was significantly more often inadequate. Multivariate analysis associated pT3-classification, former smokers, tumor-free margin status, and postoperative (chemo)radiation (PO(ch)RT) with local recurrence. Re-resections did not improve LRFS in patients with <5.0 mm tumor-free margins.
CONCLUSIONS
Adequate tumor-free margins are pivotal for LRFS of BMSCC. PO(ch)RT, not re-resection, can improve LRFS in patients with <5.0 mm tumor-free margins.
背景
对于颊黏膜鳞状细胞癌（BMSCC）局部控制的适当手术切缘仍存在争议。本研究调查了 97 例 BMSCC 患者的手术切缘和其他与局部无复发生存（LRFS）相关的因素。
方法
回顾性评估了 97 例 BMSCC 患者的多个因素。使用 Cox 回归和 Kaplan-Meier 曲线进行分析。
结果
局部复发率为 23%。89%的患者肿瘤切缘<5.0mm，深部切缘明显不足。多因素分析将 pT3 分类、曾经吸烟者、肿瘤切缘状态和术后（放）化疗（PO（ch）RT）与局部复发相关联。对于肿瘤切缘<5.0mm 的患者，再次切除并不能提高 LRFS。
结论
足够的肿瘤切缘是 BMSCC 局部无复发生存的关键。PO（ch）RT 而不是再次切除，可以改善肿瘤切缘<5.0mm 的患者的 LRFS。
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