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Multicenter Study
. 2022 Apr;42(2):126-139.
doi: 10.14639/0392-100X-N1601.

Multicentre study on resection margins in carcinoma of the oral cavity, oro-hypopharynx and larynx

Luigi Barzan  1 , Cristina Montomoli  2 , Roberto Di Carlo  3 , Martina Bertinazzi  3 , Roberta Colangeli  3 , Alessandro Martini  3 , Piero Nicolai  3 , Elena Gaio  4 , Riccardo Artico  4 , Valentina Lupato  5 , Vittorio Giacomarra  5 , Francesca Boscolo Nata  6 , Giancarlo Tirelli  6 , Lucia Lora  7 , Doriano Politi  7 , Roberto Spinato  7 , Anna Menegaldo  8 , Paolo Boscolo Rizzo  8 , Maria Cristina Da Mosto  8 , Francesco Fiorino  9 , Irene Herman  10 , Marco Benazzo  10 , Alessandro La Boria  11 , Cesare Grandi  11 , Giuseppe Fanetti  12 , Gianni Franchin  12 , Vincenzo Canzonieri  13 , Sandro Sulfaro  14 , Guido Mazzoleni  15 , Emanuela Vaccher  16
Affiliations
Multicenter Study

Multicentre study on resection margins in carcinoma of the oral cavity, oro-hypopharynx and larynx

Luigi Barzan et al. Acta Otorhinolaryngol Ital. 2022 Apr.

Abstract
in English, Italian

Objective: The prognostic significance of the resection margins is still subject of conflicting opinions. The purpose of this paper is to report the results of a study on the margins in carcinoma of the oral cavity, oro-hypopharynx and larynx.

Methods: A multicentre prospective study was carried out between 2015 and 2018 with the participation of 10 Italian reference hospitals. The primary objective was to evaluate local control in patients with well-defined clinical characteristics and comprehensive histopathological information.

Results: During the study period, 455 patients were enrolled; the minimum follow-up was 2 years. Previous treatment, grading and fresh specimen examination were identified as risk factors for local control in multivariate analysis. On the basis of these results, it seems possible to delineate "risk profiles" for different oncological outcomes.

Discussion: The prognostic significance of the margins is reduced, and other risk factors emerge, which require diversified treatment and follow-up.

Conclusions: Multidisciplinary treatment with adjuvant therapy, if indicated, reduces the prognostic importance of margins. Collaboration with a pathologist is an additional favourable prognostic factor and quality indicator.

An appendix with literature review is present in the online version.

Studio multicentrico sui margini di resezione nel carcinoma del cavo orale, faringe e laringe.

Obiettivo: Il significato prognostico dei margini di resezione è ancora oggetto di pareri discordanti. Scopo di questo scritto è riportare i risultati di uno studio sui margini nel carcinoma del cavo orale, oro-ipofaringe e laringe.

Metodi: È stato condotto uno studio prospettico multicentrico con la partecipazione di 10 Centri italiani, nel periodo 2015-2018, con l’obiettivo primario di valutare il controllo locale in pazienti con ben determinate caratteristiche cliniche e con disponibilità di esaurienti informazioni istopatologiche.

Risultati: Nel periodo in studio sono stati arruolati 455 pazienti con un follow-up minimo di 2 anni. All’analisi multivariata per il controllo locale sono risultati fattori di rischio il trattamento precedente, il grading e l’esame a fresco dello specimen. Sulla base dei risultati ottenuti è possibile delineare un “profilo di rischio” per tutti i diversi outcomes oncologici.

Discussione: Il significato prognostico dei margini è ridotto, altri fattori emergono come profili di rischio, che richiederebbero trattamento e follow-up diversificati.

Conclusioni: Il trattamento multidisciplinare con la terapia adiuvante se indicata, può aver ridimensionato l’importanza prognostica dei margini. La collaborazione con l’anatomopatologo è fattore prognostico favorevole supplementare ed indicatore di qualità.

Appendice con revisione della letteratura nella versione online.

Keywords: oral-pharyngeal-laryngeal cancer; resection margins.

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Figures

Figure 1.
Figure 1.
Tumour relapse-free survival (TRFS) for T sites other than glottic larynx. Kaplan-Meier curves based on: (a) previous treatment; (b) grading; (c) fresh specimen evaluation; (d) microscopic state of definitive margin; (e) lymphovascular invasion; (f) TNM stage; (g) perineural invasion; (h) pT; (i) pathologic nodes with ECS.
Figure 2.
Figure 2.
Diseases-pecific survival (DSS) for T site other than glottic larynx. Kaplan-Meier curves based on: (a) previous treatment; (b) frankly infiltrated margin into HE sections; (c) microscopic state of definitive margin; (d) grading; (e) lymphovascular invasion; (f) perineural invasion; (g) cN; (h) TNM stage; (i) cT; (l) pN; (m) pT; (n) pathologic nodes with ECS; (o) No. of pathologic lymph nodes.
Figure 3.
Figure 3.
Disease-specific survival (DSS) for glottic larynx as T site. Kaplan-Meier curves based on: (a) previous treatment; (b) cN; (c) tumour growth; (d) pT; (e) perineural invasion.
See this image and copyright information in PMC

References

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