Correlation between clinical and pathological data and surgical margins in patients with squamous cell carcinoma of the oral cavity.

UNLABELLED: The importance of having tumor-free margins when resecting oral neoplasms has been known for decades. OBJECTIVE: To correlate clinical and pathology data to surgical margin status in patients with squamous cell carcinoma of the tongue and floor of the mouth. METHOD: This historical cohort cross-sectional study included all patients submitted to squamous cell carcinoma resection for tumors of the oral tongue and floor of the mouth between 2007 and 2011 at the Head and Neck Surgery service of our institution. RESULTS: In the 117 cases included, 68.3% had tongue tumors. The male-to-female ratio was 2.3:1 and patient mean age was 57.6 years. Broad free resection margins were seen in 23.0% of the cases; narrow margins in 60.6% of the cases; and compromised margins in 16.2%. Tumor diameter and thickness were correlated to resection margins. Tumors in more advanced T-stages presented more unsatisfactory margins. Patients operated with broad free margins had their tumors resected more commonly through transoral approaches. CONCLUSIONS: Tumors of larger volume both in terms of diameter and thickness were more correlated to unsatisfactory resection margins. Higher complexity procedures were not associated with better resection margins.

Correlação entre dados clínico-patológicos e margens cirúrgicas em pacientes com carcinoma epidermoide da cavidade oral / Correlation between clinical and pathological data and surgical margins in patients with squamous cell carcinoma of the oral cavity

Há décadas se conhece a importância de se obter margens livres de neoplasia quando da ressecção de neoplasias de boca. OBJETIVO: Correlacionar achados clínico-patológicos com status de margem cirúrgica em pacientes com carcinoma espinocelular da língua e do assoalho da boca. MÉTODO: Forma de estudo: Estudo de coorte histórico, com corte transversal, envolvendo todos os pacientes submetidos à ressecção de carcinomas espinocelulares da língua oral e assoalho bucal entre os anos de 2007 e 2011 pelo Serviço de Cirurgia de Cabeça e Pescoço da nossa Instituição. RESULTADOS: Foram incluídos 117 casos, sendo 68.3% dos tumores localizados na língua. A relação homem:mulher foi de 2.3:1 e a média de idade foi de 57,6 anos. Ao todo, 23,0% dos casos tiveram margens de ressecção livres e amplas, 60,6% exíguas e 16,2% comprometidas. Diâmetro tumoral e espessura apresentaram correlação com margens de ressecção, sendo os tumores de estádio T mais elevados mais propensos à ressecção com margem insatisfatória. Casos operados com margens livres e amplas tiveram seus tumores ressecados mais comumente com técnicas trans-orais. CONCLUSÕES: Evidenciamos correlação entre tumores de maior volume, tanto em diâmetro quanto em espessura, com margens de ressecção insatisfatórias. Técnicas cirúrgicas de maior complexidade não tiveram associação com melhores margens de ressecção.

The importance of having tumor-free margins when resecting oral neoplasms has been known for decades. OBJECTIVE: To correlate clinical and pathology data to surgical margin status in patients with squamous cell carcinoma of the tongue and floor of the mouth. METHOD: This historical cohort cross-sectional study included all patients submitted to squamous cell carcinoma resection for tumors of the oral tongue and floor of the mouth between 2007 and 2011 at the Head and Neck Surgery service of our institution. RESULTS: In the 117 cases included, 68.3% had tongue tumors. The male-to-female ratio was 2.3:1 and patient mean age was 57.6 years. Broad free resection margins were seen in 23.0% of the cases; narrow margins in 60.6% of the cases; and compromised margins in 16.2%. Tumor diameter and thickness were correlated to resection margins. Tumors in more advanced T-stages presented more unsatisfactory margins. Patients operated with broad free margins had their tumors resected more commonly through transoral approaches. CONCLUSIONS: Tumors of larger volume both in terms of diameter and thickness were more correlated to unsatisfactory resection margins. Higher complexity procedures were not associated with better resection margins.