Independent Predictors of Prognosis Based on Oral Cavity Squamous Cell Carcinoma Surgical Margins

Marisa R Buchakjian; Timothy Ginader; Kendall K Tasche; Nitin A Pagedar; Brian J Smith; Steven M Sperry

doi:10.1177/0194599818773070

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Independent Predictors of Prognosis Based on Oral Cavity Squamous Cell Carcinoma Surgical Margins

Journal article

Open access

Peer reviewed

Independent Predictors of Prognosis Based on Oral Cavity Squamous Cell Carcinoma Surgical Margins

Marisa R Buchakjian, Timothy Ginader, Kendall K Tasche, Nitin A Pagedar, Brian J Smith and Steven M Sperry

Otolaryngology--head and neck surgery, Vol.159(4), pp.675-682

10/2018

DOI: 10.1177/0194599818773070

PMCID: PMC6341475

PMID: 29737907

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https://www.ncbi.nlm.nih.gov/pmc/articles/6341475View

Open Access

Abstract

Objective To conduct a multivariate analysis of a large cohort of oral cavity squamous cell carcinoma (OCSCC) cases for independent predictors of local recurrence (LR) and overall survival (OS), with emphasis on the relationship between (1) prognosis and (2) main specimen permanent margins and intraoperative tumor bed frozen margins. Study Design Retrospective cohort study. Setting Tertiary academic head and neck cancer program. Subjects and Methods This study included 426 patients treated with OCSCC resection between 2005 and 2014 at University of Iowa Hospitals and Clinics. Patients underwent excision of OCSCC with intraoperative tumor bed frozen margin sampling and main specimen permanent margin assessment. Multivariate analysis of the data set to predict LR and OS was performed. Results Independent predictors of LR included nodal involvement, histologic grade, and main specimen permanent margin status. Specifically, the presence of a positive margin (odds ratio, 6.21; 95% CI, 3.3-11.9) or <1-mm/carcinoma in situ margin (odds ratio, 2.41; 95% CI, 1.19-4.87) on the main specimen was an independent predictor of LR, whereas intraoperative tumor bed margins were not predictive of LR on multivariate analysis. Similarly, independent predictors of OS on multivariate analysis included nodal involvement, extracapsular extension, and a positive main specimen margin. Tumor bed margins did not independently predict OS. Conclusion The main specimen margin is a strong independent predictor of LR and OS on multivariate analysis. Intraoperative tumor bed frozen margins do not independently predict prognosis. We conclude that emphasis should be placed on evaluating the main specimen margins when estimating prognosis after OCSCC resection.

Immunohistochemistry

Multivariate Analysis

Predictive Value of Tests

Prognosis

Carcinoma, Squamous Cell - pathology

Humans

Carcinoma, Squamous Cell - surgery

Male

Neoplasm Recurrence, Local - mortality

Neoplasm Recurrence, Local - surgery

Neoplasm Recurrence, Local - pathology

Mouth - surgery

Carcinoma, Squamous Cell - mortality

Neoplasm Invasiveness - pathology

Female

Retrospective Studies

Risk Assessment

Hospitals, University

Margins of Excision

Treatment Outcome

Academic Medical Centers

Mouth Neoplasms - mortality

Disease-Free Survival

Mouth Neoplasms - surgery

Survival Analysis

Mouth - pathology

Mouth Neoplasms - pathology

Biopsy, Needle

Cohort Studies

Details

Title: Subtitle: Independent Predictors of Prognosis Based on Oral Cavity Squamous Cell Carcinoma Surgical Margins
Creators: Marisa R Buchakjian - 1 Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA
Timothy Ginader - 2 Biostatistics Core, Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa, USA
Kendall K Tasche - 1 Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA
Nitin A Pagedar - 1 Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA
Brian J Smith - 2 Biostatistics Core, Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa, USA
Steven M Sperry - 1 Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA
Resource Type: Journal article
Publication Details: Otolaryngology--head and neck surgery, Vol.159(4), pp.675-682
DOI: 10.1177/0194599818773070
PMID: 29737907
PMCID: PMC6341475
NLM abbreviation: Otolaryngol Head Neck Surg
ISSN: 1097-6817
eISSN: 1097-6817
Publisher: England
Grant note: P30 CA086862 / NCI NIH HHS
Language: English
Date published: 10/2018
Academic Unit: Biostatistics; Otolaryngology; Holden Comprehensive Cancer Center
Record Identifier: 9983997441802771

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