ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026
Optimizing outcomes: a decision-analysis model for oral cancer patients with surgical margins of 1 to 5 mm.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionAdjuvant chemoradiotherapy (CRT) was evaluated by clinical trials (RCT)and cohort analysis with significant benefit in patients with extranodal extension and compromised surgical margins. But a point of contention is the definition of clear surgical margins. This article examines the application of CRT in a cohort of patients that fulfills the surgical margin criterion for one RCT but not the other RCT. MATERIAL AND
methodsWe conducted a retrospective analysis of oral squamous cell carcinoma (OSCC) patients with surgical margins between 1 and 5 mm (mm), treated at a single center.
resultsWe analyzed 375 consecutive OSCC patients. All patients underwent radical resection, with 95 patients (26.4%) receiving adjuvant radiotherapy (RT) and 83 patients (23.1%) receiving adjuvant CRT. The mean follow-up duration was 26.2 months, during with 126 patients (33.6%) died to disease progression, and 112 patients (29.9%) experienced local recurrence. In the cohort treated by surgery alone, patients were stratified into three risk groups for local recurrence-free survival based on pathological features. Low-risk patients showed no significant benefit from adjuvant treatment, while medium-risk patients derived benefit from either RT or CRT. High-risk patients demonstrated the most significant benefit from CRT. When using disease specific survival as the outcome of interest, pN classification, the worst pattern of invasion and perineural invasion distinguished low-, medium- and high-risk patients. Adjuvant treatment provided a survival benefit for those classified as medium- and high-risk.
conclusionPatients with OSCC and surgical margins between 1 and 5mm may derive benefits from adjuvant treatment only if classified as medium- or high-risk.
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