Role of adverse pathological features in surgically treated early oral cavity carcinomas with adequate margins and the development of a scoring system to predict local control

Narayana Subramaniam, Deepak Balasubramanian*, Tsu-Hui (Hubert) Low, Samskruthi Murthy, Adharsh Anand, Chaya Prasad, Smitha N. Vijayan, Krishnakumar Thankappan, Subramania Iyer

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: The purpose of this study was to determine the factors affecting local control in patients with T1N0 squamous cell carcinoma (SCC) of the tongue. Methods: We conducted a retrospective analysis of 144 patients with pT1N0 SCC of the tongue who underwent wide excision and neck dissection without adjuvant therapy. Results: The adverse pathological features associated with local control were least margin 5 mm (P =.004), infiltrative margin (P =.403), depth >4 mm (P =.136), lymphovascular invasion (P =.301), and perineural invasion (P =.342). We derived a scoring system of 10 points based on the hazard ratio for local failure; those with scores >5 points had a 5-year local control of <60%. Conclusion: This study suggests patients having a margin of 5 mm need revision, however, if they do not have additional adverse pathological features (score ≤4), local control is 88% at 5 years, and they may be observed. Those who have margins over 5 mm with a total score >5 may still benefit from adjuvant therapy. Those with margins over 5 mm have improved local control (P =.029).

Original languageEnglish
Pages (from-to)2329-2333
Number of pages5
JournalHead and Neck
Volume40
Issue number11
DOIs
Publication statusPublished - 1 Nov 2018
Externally publishedYes

Keywords

  • adjuvant therapy
  • local control
  • oral cancer
  • T1N0
  • tongue cancer

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