title: Are wider surgical margins needed for early oral tongue cancer?
abstract: BACKGROUND
  Traditionally, a 1-cm surgical resection margin is used for early oral tongue tumours.
  
  
  METHODS
  All tumour stage one (n = 65) and stage two (n = 13) oral tongue cancers treated between January 1999 and January 2009 were followed for a median of 38 months (minimum 12 months). The sites of close and involved margins were histologically reviewed.
  
  
  RESULTS
  Involved and close margins occurred in 14 and 55 per cent of cases, respectively. The number of involved vs clear or close margins was equivalent in tumour stage one (90 vs 82 per cent), node-negative (100 vs 84 per cent) and perineural or lymphovascular invasion (20 vs 21 per cent) cases. Close or involved margins were similarly likely to be posterior (59 per cent) as anterior (41 per cent, p = 0.22), lateral (57 per cent) as medial (43 per cent, p = 0.34), and mucosal (59 per cent) as deep (41 per cent, p = 0.22). Local recurrence occurred in 28 per cent of cases at a median of 12 months, and was more likely in cases with involved (50 per cent) than clear or close margins (25 per cent, p = 0.10). Disease-free survival was worse in involved margins cases (p = 0.002).
  
  
  CONCLUSIONS
  Involved margins are common in early tongue tumours, and are associated with increased local recurrence and worse survival. Close or involved margins occur in all directions and all tumour types. A wider margin may be justified.
authors.affiliation: Division of Otolaryngology, Head and Neck Surgery, University of Melbourne, Royal Melbourne Hospital, Parkville, Victoria, Australia. iselient@hotmail.com
authors.forename: T A
authors.initials: TA
authors.lastname: Iseli
authors.forename: M J
authors.initials: MJ
authors.lastname: Lin
authors.forename: A
authors.initials: A
authors.lastname: Tsui
authors.forename: A
authors.initials: A
authors.lastname: Guiney
authors.forename: D
authors.initials: D
authors.lastname: Wiesenfeld
authors.forename: C E
authors.initials: CE
authors.lastname: Iseli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D017408:Guidelines as Topic; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D013515:Surgery, Oral / Q000592:standards*; D014062:Tongue Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D055815:Young Adult