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. 2010 Sep 15:5:79.
doi: 10.1186/1748-717X-5-79.

Buccal mucosa carcinoma: surgical margin less than 3 mm, not 5 mm, predicts locoregional recurrence

Wen-Yen Chiou  1 , Hon-Yi Lin, Feng-Chun Hsu, Moon-Sing Lee, Hsu-Chueh Ho, Yu-Chieh Su, Ching-Chih Lee, Chen-Hsi Hsieh, Yao-Ching Wang, Shih-Kai Hung
Affiliations

Buccal mucosa carcinoma: surgical margin less than 3 mm, not 5 mm, predicts locoregional recurrence

Wen-Yen Chiou et al. Radiat Oncol. .

Abstract

Background: Most treatment failure of buccal mucosal cancer post surgery is locoregional recurrence. We tried to figure out how close the surgical margin being unsafe and needed further adjuvant treatment.

Methods: Between August 2000 and June 2008, a total of 110 patients with buccal mucosa carcinoma (25 with stage I, 31 with stage II, 11 with stage III, and 43 with Stage IV classified according to the American Joint Committee on Cancer 6th edition) were treated with surgery alone (n = 32), surgery plus postoperative radiotherapy (n = 38) or surgery plus adjuvant concurrent chemoradiotherapy (n = 40).

Main outcome measures: The primary endpoint was locoregional disease control.

Results: The median follow-up time at analysis was 25 months (range, 4-104 months). The 3-year locoregional control rates were significantly different when a 3-mm surgical margin (≤3 versus >3 mm, 71% versus 95%, p = 0.04) but not a 5-mm margin (75% versus 92%, p = 0.22) was used as the cut-off level. We also found a quantitative correlation between surgical margin and locoregional failure (hazard ratio, 2.16; 95% confidence interval, 1.14 - 4.11; p = 0.019). Multivariate analysis identified pN classification and surgical margin as independent factors affecting disease-free survival and locoregional control.

Conclusions: Narrow surgical margin ≤3 mm, but not 5 mm, is associated with high risk for locoregional recurrence of buccal mucosa carcinoma. More aggressive treatment after surgery is suggested.

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Figures

Figure 1
Figure 1
Kaplan-Meier estimates of locoregional control over a 5-year period according to 2 mm cut-off surgical margins.
Figure 2
Figure 2
Kaplan-Meier estimates of locoregional control over a 5-year period according to 3 mm cut-off surgical margins.
Figure 3
Figure 3
Kaplan-Meier estimates of locoregional control over a 5-year period according to 4 mm cut-off surgical margins.
Figure 4
Figure 4
Kaplan-Meier estimates of locoregional control over a 5-year period according to 5 mm cut-off surgical margins.
See this image and copyright information in PMC

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