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Are wider surgical margins needed for early oral tongue cancer?
Traditionally, a 1-cm surgical resection margin is used for early oral tongue tumours. 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 m...
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Published in: | Journal of laryngology and otology 2012-03, Vol.126 (3), p.289-294 |
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creator | Iseli, T A Lin, M J Tsui, A Guiney, A Wiesenfeld, D Iseli, C E |
description | Traditionally, a 1-cm surgical resection margin is used for early oral tongue tumours.
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.
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).
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. |
doi_str_mv | 10.1017/S002221511100332X |
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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.
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).
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.</description><identifier>ISSN: 0022-2151</identifier><identifier>EISSN: 1748-5460</identifier><identifier>DOI: 10.1017/S002221511100332X</identifier><identifier>PMID: 22258616</identifier><identifier>CODEN: JLOTAX</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Cancer therapies ; Carcinoma, Squamous Cell - pathology ; Carcinoma, Squamous Cell - surgery ; Carcinoma, Squamous Cell - therapy ; Chemotherapy ; Combined Modality Therapy ; Disease-Free Survival ; Dissection ; Female ; Follow-Up Studies ; Guidelines as Topic ; Humans ; Kaplan-Meier Estimate ; Male ; Medical prognosis ; Medical sciences ; Metastasis ; Middle Aged ; Neck ; Neoplasm Recurrence, Local - epidemiology ; Neoplasm Staging ; Otorhinolaryngology. Stomatology ; Patients ; Radiation therapy ; Surgeons ; Surgery, Oral - standards ; Tongue ; Tongue Neoplasms - pathology ; Tongue Neoplasms - surgery ; Tongue Neoplasms - therapy ; Tumors ; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology ; Young Adult</subject><ispartof>Journal of laryngology and otology, 2012-03, Vol.126 (3), p.289-294</ispartof><rights>Copyright © JLO (1984) Limited 2012</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c401t-32813716b1324a5f046b41e5a302e9f0e7b9f7867e1a00b38c4ff0907fdec0c73</citedby><cites>FETCH-LOGICAL-c401t-32813716b1324a5f046b41e5a302e9f0e7b9f7867e1a00b38c4ff0907fdec0c73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S002221511100332X/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,72960</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25887555$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22258616$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Iseli, T A</creatorcontrib><creatorcontrib>Lin, M J</creatorcontrib><creatorcontrib>Tsui, A</creatorcontrib><creatorcontrib>Guiney, A</creatorcontrib><creatorcontrib>Wiesenfeld, D</creatorcontrib><creatorcontrib>Iseli, C E</creatorcontrib><title>Are wider surgical margins needed for early oral tongue cancer?</title><title>Journal of laryngology and otology</title><addtitle>J Laryngol Otol</addtitle><description>Traditionally, a 1-cm surgical resection margin is used for early oral tongue tumours.
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.
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).
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.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Cancer therapies</subject><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Carcinoma, Squamous Cell - surgery</subject><subject>Carcinoma, Squamous Cell - therapy</subject><subject>Chemotherapy</subject><subject>Combined Modality Therapy</subject><subject>Disease-Free Survival</subject><subject>Dissection</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Guidelines as Topic</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Neck</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Neoplasm Staging</subject><subject>Otorhinolaryngology. Stomatology</subject><subject>Patients</subject><subject>Radiation therapy</subject><subject>Surgeons</subject><subject>Surgery, Oral - standards</subject><subject>Tongue</subject><subject>Tongue Neoplasms - pathology</subject><subject>Tongue Neoplasms - surgery</subject><subject>Tongue Neoplasms - therapy</subject><subject>Tumors</subject><subject>Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology</subject><subject>Young Adult</subject><issn>0022-2151</issn><issn>1748-5460</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNp1kFtLxDAQhYMoul5-gC9SBPGpOpNL0z6JiDdY8EEF30qaTpZKt9Vki-y_N2VXBcWnBM53zswcxg4RzhBQnz8CcM5RISKAEPxlg01QyzxVMoNNNhnldNR32G4IrwDRBHyb7USXyjPMJuzi0lPy0dTkkzD4WWNNm8xN_HQh6YhqqhPX-4SMb5dJ76O66LvZQIk1nSV_sc-2nGkDHazfPfZ8c_10dZdOH27vry6nqZWAi1TwHIXGrELBpVEOZFZJJGUEcCockK4Kp_NMExqASuRWOgcFaFeTBavFHjtd5b75_n2gsCjnTbDUtqajfghlwVFjoWEkj3-Rr_3gu7jcCMmYmcsI4Qqyvg_BkyvffBPvXpYI5dht-afb6DlaBw_VnOpvx1eZEThZAybEHp2PFTXhh1N5rpVSkRPr4WZe-aae0c-K_4__BGhWja4</recordid><startdate>20120301</startdate><enddate>20120301</enddate><creator>Iseli, T A</creator><creator>Lin, M J</creator><creator>Tsui, A</creator><creator>Guiney, A</creator><creator>Wiesenfeld, D</creator><creator>Iseli, C E</creator><general>Cambridge University Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20120301</creationdate><title>Are wider surgical margins needed for early oral tongue cancer?</title><author>Iseli, T A ; Lin, M J ; Tsui, A ; Guiney, A ; Wiesenfeld, D ; Iseli, C E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c401t-32813716b1324a5f046b41e5a302e9f0e7b9f7867e1a00b38c4ff0907fdec0c73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Cancer therapies</topic><topic>Carcinoma, Squamous Cell - pathology</topic><topic>Carcinoma, Squamous Cell - surgery</topic><topic>Carcinoma, Squamous Cell - therapy</topic><topic>Chemotherapy</topic><topic>Combined Modality Therapy</topic><topic>Disease-Free Survival</topic><topic>Dissection</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Guidelines as Topic</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical sciences</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Neck</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Neoplasm Staging</topic><topic>Otorhinolaryngology. Stomatology</topic><topic>Patients</topic><topic>Radiation therapy</topic><topic>Surgeons</topic><topic>Surgery, Oral - standards</topic><topic>Tongue</topic><topic>Tongue Neoplasms - pathology</topic><topic>Tongue Neoplasms - surgery</topic><topic>Tongue Neoplasms - therapy</topic><topic>Tumors</topic><topic>Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Iseli, T A</creatorcontrib><creatorcontrib>Lin, M J</creatorcontrib><creatorcontrib>Tsui, A</creatorcontrib><creatorcontrib>Guiney, A</creatorcontrib><creatorcontrib>Wiesenfeld, D</creatorcontrib><creatorcontrib>Iseli, C E</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of laryngology and otology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Iseli, T A</au><au>Lin, M J</au><au>Tsui, A</au><au>Guiney, A</au><au>Wiesenfeld, D</au><au>Iseli, C E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Are wider surgical margins needed for early oral tongue cancer?</atitle><jtitle>Journal of laryngology and otology</jtitle><addtitle>J Laryngol Otol</addtitle><date>2012-03-01</date><risdate>2012</risdate><volume>126</volume><issue>3</issue><spage>289</spage><epage>294</epage><pages>289-294</pages><issn>0022-2151</issn><eissn>1748-5460</eissn><coden>JLOTAX</coden><abstract>Traditionally, a 1-cm surgical resection margin is used for early oral tongue tumours.
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.
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).
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.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>22258616</pmid><doi>10.1017/S002221511100332X</doi><tpages>6</tpages></addata></record> |
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subjects | Adult Aged Aged, 80 and over Biological and medical sciences Cancer therapies Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - surgery Carcinoma, Squamous Cell - therapy Chemotherapy Combined Modality Therapy Disease-Free Survival Dissection Female Follow-Up Studies Guidelines as Topic Humans Kaplan-Meier Estimate Male Medical prognosis Medical sciences Metastasis Middle Aged Neck Neoplasm Recurrence, Local - epidemiology Neoplasm Staging Otorhinolaryngology. Stomatology Patients Radiation therapy Surgeons Surgery, Oral - standards Tongue Tongue Neoplasms - pathology Tongue Neoplasms - surgery Tongue Neoplasms - therapy Tumors Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology Young Adult |
title | Are wider surgical margins needed for early oral tongue cancer? |
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