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Therapeutic Implications of Tumor Free Margins in Head and Neck Squamous Cell Carcinoma

Overview
Journal Oncotarget
Specialty Oncology
Date 2017 Nov 16
PMID 29137426
Citations 13
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Abstract

Objectives: The resection status is one of the most important prognostic factors for patients with head and neck squamous cell carcinoma (HNSCC) concerning overall survival (OS) and recurrence free interval (RFI). To assess whether therapy concepts changed depending on different resection margins and extracapsular extension, OS and RFI data were set into clinical context.

Methods: All HNSCC patients who underwent head and neck surgery with/without adjuvant therapy (n=534) were selected over a ten-year period (2001-2011). Clinical parameters and survival data were collected retrospectively and histopathological analysis of tumor free margins and extracapsular extension were done.

Results: Patients with microscopic resection showed mean OS/RFI of 95/96 months. OS/RFI decreased in microscopic macroscopic (56/58 and 35/39 months) as well as in unclear resection margins (63/60 months). Patients with extracapsular extension, microscopic - resection as well as patients with resection after follow up resection demonstrated therapy escalation by adjuvant (chemo-) radiation.

Conclusions: Insufficient surgical margins and extracapsular extension are main risks for a reduced overall and recurrence free survival. Although there is no measure to prevent positive extracapsular extension, clear margins at first pass protect patients from adjuvant therapy escalation.

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References
1.
Eloy J, Vivero R, Hoang K, Civantos F, Weed D, Morcos J . Comparison of transnasal endoscopic and open craniofacial resection for malignant tumors of the anterior skull base. Laryngoscope. 2009; 119(5):834-40. DOI: 10.1002/lary.20186. View

2.
Meier J, Oliver D, Varvares M . Surgical margin determination in head and neck oncology: current clinical practice. The results of an International American Head and Neck Society Member Survey. Head Neck. 2005; 27(11):952-8. DOI: 10.1002/hed.20269. View

3.
Bernier J, Cooper J, Pajak T, Van Glabbeke M, Bourhis J, Forastiere A . Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (# 9501). Head Neck. 2005; 27(10):843-50. DOI: 10.1002/hed.20279. View

4.
Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M . Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2014; 136(5):E359-86. DOI: 10.1002/ijc.29210. View

5.
Loree T, Strong E . Significance of positive margins in oral cavity squamous carcinoma. Am J Surg. 1990; 160(4):410-4. DOI: 10.1016/s0002-9610(05)80555-0. View