Abstract：
The specific muscular structure of the tongue greatly affects margin shrinkage and tumor invasion, making the optimal surgical margin controversial. This study investigated surgical margin correlated prognosis of TSCC (tongue squamous cell carcinoma) according to margin location and its value, and the histopathologic factors which are suggestive of tumor invasion. And we would like to propose defining of the surgical margin for TSCC via prognosis according to location and margin values. We reviewed 45 patients diagnosed with TSCC who visited Seoul National University Dental Hospital (SNUDH) (Seoul, Republic of Korea) from 2010 to 2019, who were managed by a single surgical team. Patient clinical and pathological data of patients were retrospectively reviewed, and in 36 out of 45 patients, the pathologic parameters including the worst pattern of invasion (WPOI) and tumor budding were investigated via diagnostic histopathology slide reading. When standardized with as 0.25 cm anterior margins, as 0.35 cm deep margin, there was no significant difference in disease specific survival (DSS) or loco-regional recurrence-free survival (LRFS). Additionally, there was a non-significant difference in DSS and LRFS at the nearest margin of 0.35 cm (PDSS=0.276, PLRFS=0.162). Aggressive WPOI and high tumor budding showed lower survival and recurrence-free survival, and there were significant differences in close margin and involved margin frequencies. In TSCC, the value and location of the surgical margin did not have a significant relationship with prognosis, but WPOI and tumor budding suggesting the pattern of muscle invasion affected survival and recurrence-free survival. WPOI and tumor budding should be considered when setting an optimal surgical margin.
摘要：
舌头的特定肌肉结构极大地影响边缘收缩和肿瘤侵袭，使最佳手术切缘备受争议。本研究根据舌鳞状细胞癌（TSCC）的切缘位置及其价值探讨TSCC的手术切缘预后。和提示肿瘤侵袭的组织病理学因素。并且我们想根据位置和边缘值通过预后来定义TSCC的手术边缘。我们回顾了45例诊断为TSCC的患者，他们访问了首尔国立大学牙科医院（SNUDH）（首尔，大韩民国）从2010年到2019年，由一个手术团队管理。回顾性分析患者的临床及病理资料,45名患者中有36名，通过诊断性组织病理学幻灯片阅读研究了包括最差侵袭模式(WPOI)和肿瘤出芽在内的病理参数.当标准化为0.25厘米的前缘时，如0.35厘米深的边缘，疾病特异性生存率(DSS)或局部区域无复发生存率(LRFS)无显著差异.此外,DSS和LRFS在最接近的0.35cm处无显著差异(PDSS=0.276,PLRFS=0.162)。侵袭性WPOI和高肿瘤出芽显示较低的生存率和无复发生存率，并且在接近边缘和涉及边缘频率上存在显著差异。在TSCC中,手术切缘的价值和位置与预后没有显着关系，但WPOI和肿瘤出芽提示肌肉浸润模式影响生存率和无复发生存率。设定最佳手术切缘时应考虑WPOI和肿瘤出芽。
