title: Implications of positive surgical margins.
abstract: The recently concluded Head and Neck Intergroup trial tested the addition of three courses of cis-platinum containing chemotherapy to standard treatment of surgery and postoperative radiotherapy for patients with advanced operable squamous cell carcinoma of the head and neck. Only patients with negative surgical margins were eligible for the trial. One hundred twelve patients with positive surgical margins were dropped from the trial but continued to be followed. These patients received a variety of treatments. Positive surgical margins were most often seen in nonglottic primaries and with increasing frequency as the N stage increased. Patients with positive margins who achieved a complete clinical response to subsequent treatment had a median survival of 33.8 months vs. 9.1 months for those with less than a complete clinical response. The addition of chemotherapy did not significantly alter the median survival of the positive margin patients.
authors.affiliation: Department of Otolaryngology, Wayne State University, Detroit, MI 48201.
authors.forename: J R
authors.initials: JR
authors.lastname: Jacobs
authors.forename: K
authors.initials: K
authors.lastname: Ahmad
authors.forename: R
authors.initials: R
authors.lastname: Casiano
authors.forename: D E
authors.initials: DE
authors.lastname: Schuller
authors.forename: C
authors.initials: C
authors.lastname: Scott
authors.forename: G E
authors.initials: GE
authors.lastname: Laramore
authors.forename: M
authors.initials: M
authors.lastname: al-Sarraf
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012074:Remission Induction; D015996:Survival Rate; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin