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. 2013 Nov;49(11):1083-7.
doi: 10.1016/j.oraloncology.2013.08.001. Epub 2013 Sep 17.

Dysplasia at the margin? Investigating the case for subsequent therapy in 'low-risk' squamous cell carcinoma of the oral tongue

Dennis M Sopka  1 , Tianyu Li, Miriam N Lango, Ranee Mehra, Jeffrey Chang-Jen Liu, Barbara Burtness, Douglas B Flieder, John A Ridge, Thomas J Galloway
Affiliations

Dysplasia at the margin? Investigating the case for subsequent therapy in 'low-risk' squamous cell carcinoma of the oral tongue

Dennis M Sopka et al. Oral Oncol. 2013 Nov.

Abstract

Purpose: This is a retrospective analysis of the impact of moderate dysplasia at the resection margin for early stage cancer of the oral tongue.

Materials and methods: Patients with T1-2N0 oral tongue cancer treated with surgery alone at Fox Chase Cancer Center (FCCC) from 1990 to 2010 were reviewed. Tumor and margin characteristics were abstracted from the pathology report. Overall survival (OS), disease-free survival (DFS) and local control (LC) were calculated using the Kaplan Meier method. Predictors of LC, OS and DFS were analyzed.

Results: 126 Patients met the inclusion criteria. Dysplasia was present at the final margin in 36% of the cases (severe: 9%, moderate: 15%, mild: 12%). Median follow-up was 52 months. 3 and 5-year actuarial LC for the entire cohort was 77% and 73%, respectively. Actuarial 5-year LC and DFS were significantly worse for patients with moderate or severe dysplasia at the margin vs. none or mild dysplasia at the margin (49% vs 82%, p=0.005 and 49% vs 80%, p=0.008, respectively); 3-year comparisons were not significant. When analyzed separately, the detrimental local effect of moderate dysplasia at the margin persisted (p=0.02) and the effect of severe dysplasia at the margin was approaching significance (p=0.1). Mild dysplasia at the margin did not significantly impair LC or DFS. Multivariate analysis demonstrated worse LC (HR: 2.99, p=0.006) and DFS (HR: 2.84, p=0.008) associated with severe or moderate dysplasia at the margin.

Conclusions: Both severe and moderate dysplasia at the margin appear to be correlated with inferior LC and DFS. Additional therapy may be justified, despite added morbidity.

Keywords: Dysplasia; Margin; Oral tongue cancer.

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Conflict of interest statement

Conflict of Interest Statement: None.

Figures

Figure 1
Figure 1
Locoregional control as a function of dysplasia at the final surgical margin
Figure 2
Figure 2
Disease-free survival as a function of dysplasia at the final surgical margin
See this image and copyright information in PMC

References

    1. Ganly I, Patel S, Shah J. Early stage squamous cell cancer of the oral tongue--clinicopathologic features affecting outcome. Cancer. 2012 Jan 1;118(1):101–111. - PubMed
    1. Loree TR, Strong EW. Significance of positive margins in oral cavity squamous carcinoma. American journal of surgery. 1990 Oct;160(4):410–414. - PubMed
    1. Rogers SN, Brown JS, Woolgar JA, et al. Survival following primary surgery for oral cancer. Oral oncology. 2009 Mar;45(3):201–211. - PubMed
    1. Sutton DN, Brown JS, Rogers SN, Vaughan ED, Woolgar JA. The prognostic implications of the surgical margin in oral squamous cell carcinoma. International journal of oral and maxillofacial surgery. 2003 Feb;32(1):30–34. - PubMed
    1. Cooper JS, Zhang Q, Pajak TF, et al. Long-term Follow-up of the RTOG 9501/Intergroup Phase III Trial: Postoperative Concurrent Radiation Therapy and Chemotherapy in High-Risk Squamous Cell Carcinoma of the Head and Neck. International journal of radiation oncology, biology, physics. 2012 Dec 1;84(5):1198–1205. - PMC - PubMed

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