Evidence map›Paper›PMID 41554265›Full record

ArticleClinical and experimental otorhinolaryngology2026

Impact of Margin-to-Depth of Invasion Ratio on Oncologic Outcomes in Locally Advanced Oral Cancer Treated With Surgery and Chemoradiotherapy.

Ming-Hsien Tsai, Yu-Tsai Lin, Hui-Ching Chuang, Chao-Hui Yang, Tai-Lin Huang, Hui Lu, Wen-Ling Tsai, Chih-Yen Chien, Fu-Min Fang

Abstract read
In one paragraph

Article in Clinical and experimental otorhinolaryngology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

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0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Ming-Hsien TsaiDepartment of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Yu-Tsai LinDepartment of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Hui-Ching ChuangDepartment of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Chao-Hui YangDepartment of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Tai-Lin HuangDepartment of Hematology and Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Hui LuDoctoral Program of Clinical and Experimental Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan.
Wen-Ling TsaiDepartment of Cosmetics and Fashion Styling, Center for Environmental Toxin and Emerging-Contaminant Research, Cheng Shiu University, Kaohsiung, Taiwan.
Chih-Yen ChienDepartment of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. cychien3965@adm.cgmh.org.tw.
Fu-Min FangSchool of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan. ard3779@gmail.com.

Funding

Kaohsiung Chang Gung Memorial Hospital CORPG8P0691
6 · The paper itself

Abstract

objectivesThis study aimed to evaluate the prognostic value of the margin-to-depth of invasion ratio (MDR) in patients with locally advanced oral squamous cell carcinoma (LAOSCC) who underwent curative surgery followed by adjuvant concurrent chemoradiotherapy (CCRT).

methodsWe analyzed 422 consecutive patients with LAOSCC treated at a single institution between 2007 and 2017. MDR was defined as the ratio of the closest surgical margin (mm) to the tumor depth of invasion (mm). Survival outcomes, including overall survival (OS), cancer-specific survival (CSS), and relapse-free survival (RFS), were assessed. The optimal MDR cutoff was determined by X-tile analysis and validated using repeated k-fold cross-validation.

resultsThe optimal MDR cutoff for predicting survival was 0.35. Patients with MDR ≥0.35 (high MDR, n=205) demonstrated significantly better 5-year OS (66.1% vs. 47.6%, P<0.001), CSS (77.5% vs. 57.4%, P<0.001), and RFS (71.5% vs. 53.8%, P=0.001) than those with MDR <0.35 (low MDR, n=217). In multivariate analysis, low MDR remained an independent adverse prognostic factor for OS (hazard ratio [HR], 1.612; P=0.005), CSS (HR, 2.028; P=0.001) and RFS (HR, 1.501; P=0.033). Among patients with adequate margins (≥5 mm), MDR retained significant prognostic value (OS, P=0.008; CSS, P=0.001; RFS, P=0.015). Cross-validation confirmed the robustness of the MDR threshold value of 0.35 across all survival endpoints.

conclusionMDR is an independent prognostic marker in LAOSCC treated with surgery and adjuvant CCRT. A cutoff of 0.35 effectively stratifies survival risk, even among patients with adequate surgical margins. Incorporating MDR into postoperative assessment could refine risk stratification and guide individualized follow-up and adjuvant treatment planning.

Indexed as

Concurrent ChemoradiotherapyNeoplasm InvasivenessOral Squamous Cell CarcinomaPrognosisSurgical MarginsSurvival

Identifiers

PMID41554265
PMCPMC13555243

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