根据口腔亚部位分析切缘接近对口腔癌预后的影响
Impact of Close Margins on Oral Cancer Outcomes According to the Oral Subsite.
作者信息
Sheahan Patrick, Callanan Deirdre, van den Berg Nadia, Hintze Justin, Brinkman David, Jawad Hadeel, O'Sullivan Ryan, O'Shea Ross, Dias Andrew, Feeley Linda
机构信息
Dept of Otolaryngology, South Infirmary Victoria University Hospital, Cork, Ireland.
Department of Surgery, University College Cork, Cork, Ireland.
出版信息
Head Neck. 2025 Apr;47(4):1176-1184. doi: 10.1002/hed.28024. Epub 2024 Dec 9.
BACKGROUND
The prognostic significance of close margins in oral squamous cell carcinoma (OSCC) is controversial. We wished to investigate the impact of close margins on the risk of local recurrence (LR) in OSCC according to the oral subsite.
METHODS
A retrospective cohort study of 342 OSCC patients undergoing primary surgical treatment was conducted. Surgical margins were based on the main specimen and defined as positive (SCC at margins), close (< 5 mm), or clear (≥ 5 mm).
RESULTS
Among tongue SCC cases, both positive (hazard ratio 13.48, 95% CI 2.03, 32.91) and close margins (hazard ratio 3.87, 95% CI 1.31, 11.34) were significantly associated with LR. Tongue margins < 4 mm were associated with higher LR. Among non-tongue SCC cases, only positive margins (hazard ratio 4.10, 95% CI 1.19, 14.21) were associated with LR. Close margins were not significant (hazard ratio 1.59, 95% CI 0.46, 5.42).
CONCLUSIONS
Close margins appear to have a differential impact on LR in OSCC according to the oral subsite.
背景
口腔鳞状细胞癌（OSCC）中切缘接近的预后意义存在争议。我们希望根据口腔亚部位研究切缘接近对OSCC局部复发（LR）风险的影响。
方法
对342例行原发性手术治疗的OSCC患者进行回顾性队列研究。手术切缘基于主要标本，定义为阳性（切缘处有鳞状细胞癌）、接近（<5mm）或切缘阴性（≥5mm）。
结果
在舌部鳞状细胞癌病例中，阳性切缘（风险比13.48，95%可信区间2.03，32.91）和接近切缘（风险比3.87，95%可信区间1.31，11.34）均与局部复发显著相关。舌部切缘<4mm与更高的局部复发率相关。在非舌部鳞状细胞癌病例中，只有阳性切缘（风险比4.10，95%可信区间1.19，14.21）与局部复发相关。接近切缘无显著相关性（风险比1.59，95%可信区间0.46，5.42）。
结论
根据口腔亚部位，切缘接近似乎对OSCC的局部复发有不同影响。
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