TY - JOUR
T1 - A very close margin of ≤1mm predicts a poor outcome in resected buccal cancer patients with a pathological margin of ≤3mm
AU - Tsai, Wei Ta
AU - Lee, Moon Sing
AU - Hung, Shih Kai
AU - Chiou, Wen Yen
AU - Huang, Tze Ta
AU - Tseng, Chih En
AU - Chang, Shu Mei
AU - Hsu, Feng Chun
AU - Su, Yu Chieh
AU - Li, Szu Chi
AU - Hsu, Wen Lin
AU - Liu, Dai Wei
AU - Lin, Hon Yi
N1 - Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2011/12
Y1 - 2011/12
N2 - Objectives: A close margin of ≤3mm results in a high risk for locoregional recurrence, but still is not an independent factor that helps to guide the use of aggressive postoperative therapies in patients with resected buccal mucosa carcinoma. This suggests there is a diversity of clinical outcomes in this group of patients. The present study explores the predictors among this clinically debated group of patients. Materials and Methods: From 2000 to 2008, 30 resected buccal mucosa carcinoma patients with a close margin of ≤3mm were retrospectively included in this study. All patients were treated with radical surgery together with postoperative radiotherapy (RT) or chemoradiotherapy (CCRT). Locoregional/local/regional control, disease-free status, disease-specific survival and overall survival were the study end points. Results: Two factors were observed that were able to predict 5-year locoregional control. These were a pathological N classification (pN0 vs. pN1-2, 71.5% vs. 30.0%, p=0.044) and a very close margin (>1mm vs ≤1mm, 81.8% vs. 50.7%, p=0.040). Remarkably, the predicting effect of a very close margin was well translated into disease-free status (81.8% vs. 47.1%, p=0.024) and disease-specific survival (100% vs. 70.6%, p=0.037). After multivariate analysis, a very close margin of ≤1mm was found to independently predict a high risk of locoregional recurrence (HR, 9.528; 95% CI, 1.326-18.481; p=0.025) and disease failure at any site (HR, 12.778; 95% CI, 1.934-25.217; p=0.013). Conclusion: More aggressive postoperative treatments should be considered for resected buccal mucosa carcinoma patients with a very close margin of ≤1mm.
AB - Objectives: A close margin of ≤3mm results in a high risk for locoregional recurrence, but still is not an independent factor that helps to guide the use of aggressive postoperative therapies in patients with resected buccal mucosa carcinoma. This suggests there is a diversity of clinical outcomes in this group of patients. The present study explores the predictors among this clinically debated group of patients. Materials and Methods: From 2000 to 2008, 30 resected buccal mucosa carcinoma patients with a close margin of ≤3mm were retrospectively included in this study. All patients were treated with radical surgery together with postoperative radiotherapy (RT) or chemoradiotherapy (CCRT). Locoregional/local/regional control, disease-free status, disease-specific survival and overall survival were the study end points. Results: Two factors were observed that were able to predict 5-year locoregional control. These were a pathological N classification (pN0 vs. pN1-2, 71.5% vs. 30.0%, p=0.044) and a very close margin (>1mm vs ≤1mm, 81.8% vs. 50.7%, p=0.040). Remarkably, the predicting effect of a very close margin was well translated into disease-free status (81.8% vs. 47.1%, p=0.024) and disease-specific survival (100% vs. 70.6%, p=0.037). After multivariate analysis, a very close margin of ≤1mm was found to independently predict a high risk of locoregional recurrence (HR, 9.528; 95% CI, 1.326-18.481; p=0.025) and disease failure at any site (HR, 12.778; 95% CI, 1.934-25.217; p=0.013). Conclusion: More aggressive postoperative treatments should be considered for resected buccal mucosa carcinoma patients with a very close margin of ≤1mm.
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U2 - 10.1016/j.tcmj.2011.10.005
DO - 10.1016/j.tcmj.2011.10.005
M3 - Article
AN - SCOPUS:84855320857
SN - 1016-3190
VL - 23
SP - 123
EP - 130
JO - Tzu Chi Medical Journal
JF - Tzu Chi Medical Journal
IS - 4
ER -