Oncologic significance of the lateral margin in buccal cancer

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology Pub Date : 2025-02-07 DOI:10.1016/j.oraloncology.2025.107212

Muthuswamy Dhiwakar , Sneha Kamalakkannan , Deeksha Dhiwakar , Nithyanand Chidambaranathan , Rajeshwari Muthusamy , Pirabu Sakthivel , Firoz Rajan

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引用次数: 0

Abstract

Objective

To evaluate the specific oncologic significance of the lateral margin (LM)- the marginal plane closest to skin- in resected buccal cancer.

Materials and methods

216 consecutive, treatment naïve patients undergoing primary surgery for buccal cancer were included. Cheek skin was resected based on clinical features of skin or subcutaneous involvement or proximity to oral commissure. Main outcomes were 1) frequency of LM ≤1 mm in relation to other (anterior, posterior, superior and inferior) margins and 2) association of LM ≤1 mm with LRFS and DFS. Secondary outcomes were rate of LM ≤1 mm and size of LM with and without skin resection.

Results

A total of 67 (31 %) patients had one or more margin ≤1 mm, of which LM comprised 36 (54 %). LM ≤1 mm was disproportionately highest among the five marginal planes (p < 0.001) and was independently associated with LRFS and DFS. Both associations held in sensitivity analysis wherein patients with co-existent margin ≤1 mm at any of the other four marginal planes underwent group-wise exclusion. Skin resection and preservation was performed in 61 (28 %) and 155 (72 %) patients respectively. The latter had a higher rate of LM ≤1 mm and smaller LM size (both p < 0.05).

Conclusions

This cohort study of buccal cancer shows that LM is most prone for ≤1 mm size. LM ≤1 mm predicts worse LRFS and DFS independent of other margins and risk factors. As skin preservation is associated with a higher rate of LM ≤1 mm, surgeons must lower the threshold to encompass more tissue laterally, including skin where appropriate.

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来源期刊

Oral oncology 医学-牙科与口腔外科

CiteScore

8.70

自引率

10.40%

发文量

505

审稿时长

20 days

期刊介绍： Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.