. 2021 Dec 21;14(1):15.

doi: 10.3390/cancers14010015.

Surgical Margins Status and Prognosis after Resection of Oral Cavity Squamous Cell Carcinoma: Results from a Taiwanese Nationwide Registry-Based Study

Chung-Jan Kang¹, Yu-Wen Wen^{2

3}, Shu-Ru Lee⁴, Li-Yu Lee⁵, Chuen Hsueh⁵, Chien-Yu Lin⁶, Kang-Hsing Fan⁶, Hung-Ming Wang⁷, Chia-Hsun Hsieh⁷, Shu-Hang Ng⁸, Chih-Hua Yeh⁸, Chih-Hung Lin⁹, Chung-Kan Tsao⁹, Tuan-Jen Fang¹, Shiang-Fu Huang¹, Li-Ang Lee¹, Ku-Hao Fang¹, Tzu-Chen Yen¹⁰, Nai-Ming Cheng¹⁰, Tsung-You Tsai¹, Shiao-Fwu Tai¹, Chi-Ying Tsai¹¹

Affiliations

¹ Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan 333, Taiwan.
² Clinical Informatics and Medical Statistics Research Center, Medical College of Chang Gung University, Taoyuan 333, Taiwan.
³ Division of Thoracic Surgery, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.
⁴ Research Service Center for Health Information, Chang Gung University, Taoyuan 333, Taiwan.
⁵ Department of Pathology, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan 333, Taiwan.
⁶ Department of Radiation Oncology, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan 333, Taiwan.
⁷ Department of Medical Oncology, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan 333, Taiwan.
⁸ Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan 333, Taiwan.
⁹ Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan 333, Taiwan.
¹⁰ Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan 333, Taiwan.
¹¹ Department of Oral and Maxillofacial Surgery, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan 333, Taiwan.

PMID: 35008181
PMCID: PMC8749941
DOI: 10.3390/cancers14010015

Surgical Margins Status and Prognosis after Resection of Oral Cavity Squamous Cell Carcinoma: Results from a Taiwanese Nationwide Registry-Based Study

Chung-Jan Kang et al. Cancers (Basel). 2021.

. 2021 Dec 21;14(1):15.

doi: 10.3390/cancers14010015.

Authors

Affiliations

¹ Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan 333, Taiwan.
² Clinical Informatics and Medical Statistics Research Center, Medical College of Chang Gung University, Taoyuan 333, Taiwan.
³ Division of Thoracic Surgery, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.
⁴ Research Service Center for Health Information, Chang Gung University, Taoyuan 333, Taiwan.
⁵ Department of Pathology, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan 333, Taiwan.
⁶ Department of Radiation Oncology, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan 333, Taiwan.
⁷ Department of Medical Oncology, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan 333, Taiwan.
⁸ Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan 333, Taiwan.
⁹ Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan 333, Taiwan.
¹⁰ Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan 333, Taiwan.
¹¹ Department of Oral and Maxillofacial Surgery, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan 333, Taiwan.

PMID: 35008181
PMCID: PMC8749941
DOI: 10.3390/cancers14010015

Abstract

(1) Background: The optimal cutoff value that maximizes the prognostic value of surgical margins in patients with resected oral cavity squamous cell carcinoma has not yet been identified. (2) Methods: Data for this study were retrieved from the Taiwan Cancer Registry Database. A total of 13,768 Taiwanese patients with oral cavity squamous cell carcinoma were identified and stratified according to different margin statuses (0, 0.1-4 and > 4 mm). The five-year local control, disease-specific survival and overall survival rates were the main outcome measures. (3) Results: The 5-year local control, disease-specific survival and overall survival rates of patients with close margins (0 and 0.1-4 mm) were significantly lower than those observed in patients with clear margins (> 4 mm; all p values < 0.001). In multivariate analysis, margin status, depth of invasion and extra-nodal extension were identified as independent adverse prognostic factors for 5-year local control. (4) Conclusions: A thorough assessment of surgical margins can provide a reliable prognostic prediction in patients with OCSCC. This has potential implications for treatment approaches tailored to the individual level. The achievement of clear margins (>4 mm) should be considered a key surgical goal to improve outcomes in this patient group.

Keywords: local control; nationwide registry study; oral cavity squamous cell carcinoma; outcome; surgical margin.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
Flow of patients through the study. OCSCC, oral squamous cell carcinoma.

**Figure 2**
(A) Five-year local control rates of patients with oral cavity squamous cell carcinoma stratified according to different margin statuses (0, 0.1–4 and > 4 mm); (B) five-year disease-specific survival rates of patients with oral cavity squamous cell carcinoma stratified according to different margin statuses (0, 0.1–4 and > 4 mm); (C) five-year overall survival rates of patients with oral cavity squamous cell carcinoma stratified according to different margin statuses (0, 0.1–4 and > 4 mm).

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Surgical Margins Status and Prognosis after Resection of Oral Cavity Squamous Cell Carcinoma: Results from a Taiwanese Nationwide Registry-Based Study

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Surgical Margins Status and Prognosis after Resection of Oral Cavity Squamous Cell Carcinoma: Results from a Taiwanese Nationwide Registry-Based Study

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