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口腔癌局部复发的手术切缘距离毫米分层:系统评价和荟萃分析。

Stratification of surgical margin distances by the millimeter on local recurrence in oral cavity cancer: A systematic review and meta-analysis.

机构信息

John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, USA.

Department of Otolaryngology - Head and Neck Surgery, University of California, Davis, Sacramento, California, USA.

出版信息

Head Neck. 2023 May;45(5):1305-1314. doi: 10.1002/hed.27339. Epub 2023 Mar 9.

Abstract

There are limited data supporting the commonly suggested 5 mm margin cutoff as the optimum value in defining clear margins in oral cancer. A database search of Pubmed/Medline, Web of Science, and EBSCOhost was performed from inception to June 2022. A random-effects model was chosen for this meta-analysis. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed throughout this study. Seven studies met study criteria (2215 patients). The risk ratio was significantly higher for margins <5 mm when compared to those ≥5 mm (2.09 (95%CI: 1.53-2.86, I  = 0.47)). Subgroup analysis (I  = 0.15) of margin distances of 0.0-0.9, 1.0-1.9, 2.0-2.9, 3.0-3.9, and 4.0-4.9 mm calculated risk ratios for local recurrence of 2.96, 2.01, 2.17, 1.8, and 0.98, respectively. Margins between 4.0 and 4.9 mm had similar risk ratios for local recurrence compared to ≥5 mm, while margins <4.0 were significantly higher.

摘要

目前仅有有限的数据支持将 5mm 作为口腔癌中定义清晰切缘的最佳值的建议。对 Pubmed/Medline、Web of Science 和 EBSCOhost 数据库进行了从建库到 2022 年 6 月的检索。本荟萃分析选择了随机效应模型。本研究全程遵循了系统评价和荟萃分析的 Preferred Reporting Items(PRISMA)指南。有 7 项研究符合纳入标准(2215 例患者)。与切缘≥5mm 相比,切缘<5mm 的风险比明显更高(2.09(95%CI:1.53-2.86,I²=0.47))。亚组分析(I²=0.15)显示,切缘距离为 0.0-0.9、1.0-1.9、2.0-2.9、3.0-3.9 和 4.0-4.9mm 时,局部复发的风险比分别为 2.96、2.01、2.17、1.8 和 0.98。与切缘≥5mm 相比,4.0-4.9mm 之间的切缘局部复发风险比相似,而<4.0mm 的切缘风险比显著更高。

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