Bellini Elisa, Pace Gian Marco, Marchi Filippo, Paderno Alberto, Zimello Camilla, Pennacchi Alessia, Mercante Giuseppe, Peretti Giorgio, Spriano Giuseppe, Iandelli Andrea
Unit of Otorhinolaryngology-Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy.
Acta Otorhinolaryngol Ital. 2025 May;45(Suppl. 1):S2-S14. doi: 10.14639/0392-100X-suppl.1-45-2025-N1044.
The aim of this study is to analyse the impact of surgical margins on survival outcomes for patients with oral cavity squamous cell carcinoma (OCSCC).
Pooled hazard ratios (HRs) and 95% confidence interval (CI) were calculated to define the impact of positive and close margins on overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS).
A total of 14 studies enrolling 4839 patients (of whom 3837 males, or 79.3%), with a median age of 59 years, were included. The incidence of positive margins was 9.1%, while that of close margins was 27.3%. The estimated pooled HRs for patients with positive surgical margins were 2.265 (95% CI: 1.431-3.584; p = 0.003) for OS, 2.076 (95% CI: 1.652-2.608; p < 0.001) for DFS, and 2.163 (95% CI: 1.349-3.468; p = 0.014) for DSS. For patients with close margins, the HRs were 1.409 (95% CI: 1.064-1.866; p = 0.024) for OS, 1.775 (95% CI: 0.910-3.462; p = 0.078) for DFS, and 1.123 (95% CI: 0.425-2.974; p = 0.658) for DSS.
Positive surgical margins are a significant prognostic factor in OCSCC. Further studies are required to better define the impact of close margins.
本研究旨在分析手术切缘对口腔鳞状细胞癌（OCSCC）患者生存结局的影响。
计算合并风险比（HRs）和95%置信区间（CI），以确定阳性切缘和近切缘对总生存期（OS）、无病生存期（DFS）和疾病特异性生存期（DSS）的影响。
共纳入14项研究，涉及4839例患者（其中男性3837例，占79.3%），中位年龄为59岁。阳性切缘的发生率为9.1%，近切缘的发生率为27.3%。手术切缘阳性患者的OS合并HR估计值为2.265（95%CI：1.431 - 3.584；p = 0.003），DFS为2.076（95%CI：1.652 - 2.608；p < 0.001），DSS为2.163（95%CI：1.349 - 3.468；p = 0.014）。对于近切缘患者，OS的HR为1.409（95%CI：1.064 - 1.866；p = 0.024），DFS为1.775（95%CI：0.910 - 3.462；p = 0.078），DSS为1.123（95%CI：0.425 - 2.974；p = 0.658）。
手术切缘阳性是OCSCC的一个重要预后因素。需要进一步研究以更好地确定近切缘的影响。
