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Prognostic importance of “clear versus revised margins” in oral and pharyngeal cancer
Author(s) -
Kwok Pingling,
Gleich Otto,
Hübner Gerhard,
Strutz Jürgen
Publication year - 2010
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.21349
Subject(s) - medicine , pharynx , head and neck cancer , cancer , floor of mouth , head and neck , overall survival , frozen section procedure , survival rate , surgery , resection , oral cavity , dentistry
Background. Opinions differ regarding the usefulness of accurate, but costly, frozen sections. Most physicians believe that negative margins are essential for the prognosis of patients with oral and pharyngeal cancer. We examined whether immediate repeated resections in patients with positive margins, based on findings from frozen sections, resulted in improved patient survival. Methods. Data from 417 patients identified with cancer of the pharynx and floor of the mouth were analyzed retrospectively. Results. The 5‐year survival rate for R0 and R1–R0 groups was 72% to 76% and was significantly better ( p ≤ .034) than that for R1 and R2 groups (58%, 40%). Despite clear margins, large tumors had a poorer prognosis than that of small tumors. Conclusions. Patients receiving repeated resection had the same survival rate as patients who had the tumor resected immediately with negative margins. The use of frozen sections yields a benefit for 15.6% of the operated patients and increases the overall 5‐year survival rate by 2% to 3%. © 2010 Wiley Periodicals, Inc. Head Neck, 2010