Tuesday, December 14, 2021

The impact of worst pattern of invasion on the extension of surgical margins in oral squamous cell carcinoma

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Abstract

Background

To evaluate margins for oral carcinoma according to types of invasion front.

Methods

Retrospective cohort of 772 patients with worst pattern of invasion (WPOI) graded 1–5. Local recurrence was the outcome of interest.

Results

Local recurrences occurred in 164 patients (21.2%) and was affected by WPOI type 4/5, margin distance, perineural invasion, and adjuvant radiotherapy. In patients with WPOI types 1/2/3, a cutoff of 1.7 mm was considered ideal margin extent and in patients with WPOI types 4/5, the cutoff was 7.8 mm. Patients below these thresholds had a significantly higher incidence of local recurrence.

Conclusions

Different WPOI determine the ideal extent of surgical margins as 1.7 mm for patients with types 1–3, and 7.8 mm in patients with types 4/5.

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