The clinical relevance of epithelial dysplasia in the surgical margins of tongue and floor of mouth squamous cell carcinoma: an analysis of 37 patients.
BACKGROUND
The clinical relevance of the presence of epithelial dysplasia in the margins of surgically removed oral squamous cell carcinoma is still unclear.


METHODS
In a retrospective study, the presence of mild or moderate epithelial dysplasia in the surgical margins of tongue and floor of mouth squamous cell carcinoma was examined histologically. Patients with tumor cells within 0.5 cm of the surgical margins were excluded. Also patients with severe dysplasia were excluded, as this is usually regarded as carcinoma in situ. Patients that received postoperative irradiation were also excluded. Only patients who completed a follow-up period of five years were included. All together, a total number of 37 patients fulfilled the inclusion criteria.


RESULTS
Epithelial dysplasia was observed in 7 out of the 37 patients. Five of these patients, and two of the 30 patients with no dysplasia, had a local recurrence (P < 0.01).


CONCLUSIONS
The presence of mild or moderate epithelial dysplasia in the margins of surgically removed oral squamous cell carcinoma carries a significant risk for the development of local recurrence. However, it should be noted that this study was of a retrospective nature and that the group of patients with epithelial dysplasia in the surgical margins was rather small. On the other hand, the inclusion criteria were somewhat strict, by limiting the oral subsite to tongue/floor of mouth, by excluding patients in whom tumors cell were found within 0.5 cm of the surgical margins and by excluding patients who received postoperative radiotherapy, amongst others.
Weijers
M
M
Department of Oral and Maxillofacial Surgery/Pathology, University Hospital Vrije Universiteit/ACTA, Amsterdam, The Netherlands.
Snow
G B
GB
Bezemer
P D
PD
van der Wal
J E
JE
van der Waal
I
I
D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D004396:Coloring Agents; D004801:Eosine Yellowish-(YS); D004848:Epithelium / Q000473:pathology; D005260:Female; D005456:Fluorescent Dyes; D005500:Follow-Up Studies; D006416:Hematoxylin; D006801:Humans; D008297:Male; D008875:Middle Aged; D009060:Mouth Floor / Q000473:pathology* / Q000601:surgery; D009061:Mouth Mucosa / Q000473:pathology*; D009062:Mouth Neoplasms / Q000473:pathology* / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking; D013223:Statistics as Topic; D014059:Tongue / Q000473:pathology*; D014062:Tongue Neoplasms / Q000473:pathology* / Q000601:surgery
D004396:Coloring Agents; D005456:Fluorescent Dyes; D004801:Eosine Yellowish-(YS); D006416:Hematoxylin