PDF(Pubmed)
Abstract：
In patients with oral cancer, the risk factors for local, regional, and distant recurrence according to margin status have not been well established. We aimed to determine the risk factors for recurrence by margin status and to identify a margin cut-off point for improved survival in patients with close margins. We retrospectively reviewed adult patients treated at our centre from 2009 to 2021 for primary oral cancer. Margins were classified as positive (<1 mm), close (1 to 4.9 mm), or clear (>5 mm). Univariate and multivariate analyses were performed. A total of 326 patients (210 men) were included. The mean age was 59.1 years. Margin status was close (n = 168, 51.5%), clear (n = 83, 25.4%), or positive (n = 75, 23.0%). In the univariate analysis, positive surgical margins (HR = 7.53) had the greatest impact on distant failure. Positive surgical margins-without nodal involvement-had the greatest impact on the risk of distant failure. In the close margin group, the optimal cut-off for disease-free survival (AUC = 0.58) and overall survival (AUC = 0.63) was a deep margin > 3 mm, with survival outcomes that were comparable to the clear margin group. These finding suggest that margins < 5 mm may be sufficient in certain well-defined cases. Prospective studies are warranted to confirm these findings.
摘要：
在口腔癌患者中，当地的风险因素，区域,根据边缘状态的远处复发尚未确定。我们旨在通过切缘状态确定复发的危险因素，并确定切缘截止点，以改善切缘患者的生存率。我们回顾性回顾了2009年至2021年在我们中心接受治疗的原发性口腔癌的成年患者。边缘被分类为正（<1毫米），关闭（1至4.9毫米），或清除（>5毫米）。进行单变量和多变量分析。共纳入326名患者（210名男性）。平均年龄为59.1岁。利润率接近(n=168，51.5%)，清除（n=83，25.4%），或阳性（n=75，23.0%）。在单变量分析中，手术切缘阳性(HR=7.53)对远处衰竭的影响最大.无淋巴结累及的阳性手术切缘对远处衰竭的风险影响最大。在接近边距组中，无病生存期（AUC=0.58）和总生存期（AUC=0.63）的最佳截止是深度边缘>3mm，生存结局与清晰边缘组相当.这些发现表明,在某些明确定义的情况下,边缘<5mm可能是足够的。有必要进行前瞻性研究以证实这些发现。
