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. 2025 Jul;91 Suppl 1(Suppl 1):101624.
doi: 10.1016/j.bjorl.2025.101624. Epub 2025 May 14.

Oncologic outcomes of microscopic tumor cut through in locally advanced oral squamous cell carcinoma

Guilherme Reimann Agne  1 , Hugo Fontan Kohler  2 , Thiago Celestino Chulam  2 , Clóvis Antônio Lopes Pinto  3 , José Guilherme Vartanian  2 , Luiz Paulo Kowalski  2
Affiliations

Oncologic outcomes of microscopic tumor cut through in locally advanced oral squamous cell carcinoma

Guilherme Reimann Agne et al. Braz J Otorhinolaryngol. 2025 Jul.

Abstract

Objective: This study aims to determine the impact of MTCT on local recurrence and disease-specific survival in patients with locally advanced T3-T4 OCSCC and compare it with other clinicopathological variables.

Methods: A retrospective database analysis of patients diagnosed with locally advanced T3-T4 OCSCC surgically treated and submitted to intraoperative frozen section guiding the margin status. Survival was analyzed using the Kaplan-Meier estimator followed by the Cox model for multivariate analysis.

Results: We analyzed 475 patients who met inclusion criteria: MTCT occurred in 29 patients (6.11%) and local recurrence was observed in 131 patients (27.6%). MTCT had an impact on univariate (HR = 2.205; 95% CI 1.243-3.914; p = 0.007) and multivariate (HR = 1.851; 95% CI 1.285-2.666; p = 0.001) analyses. Similar results were found for disease-specific survival: univariate (HZ = 1.669; 95% CI 1.056-2.635; p = 0.028) and multivariate (HZ = 1.307; 95% CI 0.816-2.092; p = 0.265) analyses. A total of 231 patients (48.6%) had died of cancer by the end of follow-up. The best predictor for compromised frozen sections was tumor depth of invasion.

Conclusion: Even after negative final margins, MTCT is an important factor associated with poorer outcome, and treatment intensification should be considered in these patients.

Level of evidence: Level III.

Keywords: Frozen sections; Margins of excision; Mouth neoplasm.

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Conflict of interest statement

Declaration of competing interest The authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
ROC (Receiver Operator Characteristic) curve for compromised surgical margins according to tumor DOI.
See this image and copyright information in PMC

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