Prognostic importance of "clear versus revised margins" in oral and pharyngeal cancer.
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%.
Kwok
Pingling
P
ENT Department, University of Regensburg, Regensburg, Germany.
Gleich
Otto
O
Hübner
Gerhard
G
Strutz
Jürgen
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D005629:Frozen Sections; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D010610:Pharyngeal Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D015996:Survival Rate