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

• Published in: Head & neck 2022-03, Vol.44 (3), p.691-697
• Main Authors: Köhler, Hugo Fontan, Vartanian, José Guilherme, Pinto, Clóvis Antônio Lopes, Silva Rodrigues, Ivete Fabelo Pereira, Kowalski, Luiz Paulo
• Format: Article
• Language: English
• Subjects: Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Head and Neck Neoplasms - pathology; Humans; Margins of Excision; mouth neoplasms; Mouth Neoplasms - pathology; Mouth Neoplasms - surgery; Neoplasm Invasiveness - pathology; neoplasm recurrence; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Oral cancer; Oral carcinoma; Oral squamous cell carcinoma; pathology; Prognosis; Radiation therapy; Retrospective Studies; Squamous cell carcinoma; Squamous Cell Carcinoma of Head and Neck - pathology; surgery
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.26956

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.