Research ArticleOpen Access

Factors Influencing the Status of the Surgical Margin in the Resection of Oral Squamous Cell Carcinoma

Volume 1 - Issue 7

KFB Payne*

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- Oral and Maxillofacial Surgery Specialist Registrar, West Midlands Deanery, UK
*Corresponding author: KFB Payne, Oral and Maxillofacial Surgery Specialist Registrar, West Midlands Deanery, UK

Received: November 15, 2017; Published: December 04, 2017

DOI: 10.26717/BJSTR.2017.01.000562

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Abstract

Aim: Surgical margin status in the resection of oral squamous cell carcinoma (OSCC) is a significant prognostic indicator of recurrence and long term outcome. We sought to investigate the factors (patient, tumour and surgical) at time of surgery that influenced the ability to achieve adequate surgical margins.

Method: We retrospectively reviewed patients who had undergone primary resection of OSCC. Over a 4-year period (2012-2015) 100 patients were surgically treated. Histological derived margins were classified as clear (≥5mm), close (<5mm) or involved (tumour present at resection margin).

Results: Overall, 49%, 45% and 6% had clear, close and involved margins respectively. Of the 100 patients, 28 had stage I, 21 stages II, 7 stages III and 44 stage IV diseases. No relationship was evident between margin status and sex, age (<65), surgical access or individual surgeon. Maximum tumour diameter and depth of invasion were significant factors relating to poorer margins (p=0.015 and 0.021). Tumour site appeared to have no impact upon margin status. The histological feature of bone invasion had a significant impact upon poorer margins (p=0.015), as did a positive node status (p=0.0054). We were unable to correlate lymphovascular or perineural invasion with margin status.

Discussion: We highlight tumour factors which appear to influence the margin status of resected OSCC, notably tumour size and depth, nodal spread and bone invasion. These all correlate to advanced stage disease being more difficult to treat. Our findings further stress the importance of being able to identify and delineate tumour mass intra-operatively to facilitate a clear resection margin.

Keywords: Head and Neck cancer; Oral squamous cell carcinoma; Surgical margin; Tumour Resection