Early oral cancer: margin revision fails to improve local control

  • Bulbul MG & al.
  • Otolaryngol Head Neck Surg
  • 26 Mar 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Revision of initially positive surgical margins based on frozen section analysis fails to improve locoregional recurrence-free survival (LRFS) in early oral cavity cancer (OCC), according to a systematic review and meta-analysis.

Why this matters

  • Current practice is to use margins from intraoperative frozen sections to guide the need for further resection.

Key results

  • Patients with positive/close margins that were cleared with further resection had lower LRFS than those with initially negative margins (HR, 2.592; P<.001 style="list-style-type:circle;">
  • HR, 2.575; P=.014 in patients with tongue cancer.
  • HR, 3.439; P=.001 in patients with floor of mouth cancer.
  • HR, 2.278; P=.025 in patients with other OCC sites.
  • Patients with positive/close margins that were not cleared with further resection had reduced LRFS compared with patients with initially negative margins (HR, 3.672; P<.001>
  • Patients with positive/close margins that were cleared with further resection had similar LRFS to patients with positive/close margins that were not cleared with further resection (HR, 1.523; P=.055).
  • Study design

    • 8 studies involving 1427 patients with OCC were included in the meta-analysis.
    • Study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) system.
    • Funding: None.

    Limitations

    • Retrospective studies.

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