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Oncologic outcomes of microscopic tumor cut-through in locally advanced oral squamous cell carcinoma
Agne, Guilherme Reimann; Kohler, Hugo Fontan; Chulam, Thiago Celestino; Pinto, Clóvis Antônio Lopes; Vartanian, José Guilherme; Kowalski, Luiz Paulo.
Afiliación
  • Agne, Guilherme Reimann; A.C. Camargo Cancer Center. Departamento de Cirurgia de Cabeça e Pescoço e Otorrinolaringologia. São Paulo. BR
  • Kohler, Hugo Fontan; A.C. Camargo Cancer Center. Departamento de Cirurgia de Cabeça e Pescoço e Otorrinolaringologia. São Paulo. BR
  • Chulam, Thiago Celestino; A.C. Camargo Cancer Center. Departamento de Cirurgia de Cabeça e Pescoço e Otorrinolaringologia. São Paulo. BR
  • Pinto, Clóvis Antônio Lopes; A.C. Camargo Cancer Center. Departamento de Patologia. São Paulo. BR
  • Vartanian, José Guilherme; A.C. Camargo Cancer Center. Departamento de Cirurgia de Cabeça e Pescoço e Otorrinolaringologia. São Paulo. BR
  • Kowalski, Luiz Paulo; A.C. Camargo Cancer Center. Departamento de Cirurgia de Cabeça e Pescoço e Otorrinolaringologia. São Paulo. BR
Arch. Head Neck Surg ; 51: e20220013, Jan-Dec. 2022.
Article en En | LILACS-Express | LILACS | ID: biblio-1401084
Biblioteca responsable: BR935
ABSTRACT

Introduction:

The gold standard treatment of oral cavity squamous cell carcinoma (OCSCC) is surgical resection; however, standardization of the margins and the role of frozen section are still debatable. Microscopic tumor cut-thought (MTCT) occurs when the surgeon has an initial positive frozen section margin that is cleared with further resection to negative.

Objective:

This study aims to determine the impact of MTCT on local recurrence and disease-specific survival in patients with locally advanced T3-T4 OCSCC and compare it with other clinicopathological variables.

Methods:

A retrospective database analysis of patients diagnosed with locally advanced T3-T4 OCSCC surgically treated and submitted to intraoperative frozen section guiding the margin status. Survival was analyzed using the Kaplan-Meier estimator followed by the Cox model for multivariate analysis.

Results:

We analyzed 475 patients who met inclusion criteria MTCT occurred in 29 patients (6.11%) and local recurrence was observed in 131 patients (27.6%). MTCT had an impact on univariate (HR 2.205; 95% CI 1.243 ­ 3.914; p=0.007) and multivariate (HR 1.851; 95% CI 1.285 ­ 2.666; p=0.001) analyses. Similar results were found for disease-specific survival univariate (HZ 1.669; 95% CI 1.056 ­ 2.635; p=0.028) and multivariate (HZ 1.307; 95% CI 0.816 ­ 2.092; p=0.265) analyses. A total of 231 patients (48.6%) had died of cancer by the end of follow-up. The best predictor for compromised frozen sections was tumor depth of invasion.

Conclusion:

Even after negative final margins, MTCT is an important factor associated with poorer outcome, and treatment intensification should be considered in these patients.
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CC BY - Atribuição

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Texto completo: 1 Colección: 01-internacional Base de datos: LILACS Tipo de estudio: Prognostic_studies Idioma: En Revista: Arch. Head Neck Surg Asunto de la revista: Ciˆncias da Sa£de / Medicina Año: 2022 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Brasil
Texto completo
Añadir a Mi BVS
Imprimir
XML
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: LILACS Tipo de estudio: Prognostic_studies Idioma: En Revista: Arch. Head Neck Surg Asunto de la revista: Ciˆncias da Sa£de / Medicina Año: 2022 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Brasil