Are wider surgical margins needed for early oral tongue cancer?

T. A. Iseli, M. J. Lin, A. Tsui, A. Guiney, D. Wiesenfeld, C. E. Iseli

Research output: Contribution to journalArticlepeer-review

40 Scopus citations

Abstract

Background: Traditionally, a 1-cm surgical resection margin is used for early oral tongue tumours.Methods: All tumour stage one (n = 65) and stage two (n = 13) oral tongue cancers treated between January 1999 and January 2009 were followed for a median of 38 months (minimum 12 months). The sites of close and involved margins were histologically reviewed.Results: Involved and close margins occurred in 14 and 55 per cent of cases, respectively. The number of involved vs clear or close margins was equivalent in tumour stage one (90 vs 82 per cent), node-negative (100 vs 84 per cent) and perineural or lymphovascular invasion (20 vs 21 per cent) cases. Close or involved margins were similarly likely to be posterior (59 per cent) as anterior (41 per cent, p = 0.22), lateral (57 per cent) as medial (43 per cent, p = 0.34), and mucosal (59 per cent) as deep (41 per cent, p = 0.22). Local recurrence occurred in 28 per cent of cases at a median of 12 months, and was more likely in cases with involved (50 per cent) than clear or close margins (25 per cent, p = 0.10). Disease-free survival was worse in involved margins cases (p = 0.002).Conclusion: Involved margins are common in early tongue tumours, and are associated with increased local recurrence and worse survival. Close or involved margins occur in all directions and all tumour types. A wider margin may be justified.

Original languageEnglish
Pages (from-to)289-294
Number of pages6
JournalJournal of Laryngology and Otology
Volume126
Issue number3
DOIs
StatePublished - Mar 2012
Externally publishedYes

Keywords

  • Carcinoma, Squamous Cell
  • Neoplasm Recurrence, Local
  • Oral Cavity
  • Surgical Margin
  • Surgical Procedures, Operative
  • Survival
  • Tongue

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