Logo of brjcancerBJC HomepageBJC Advance online publicationBJC Current IssueSubmitting an article to BJCWeb feeds
Br J Cancer. Jul 1996; 74(1): 128–132.
PMCID: PMC2074609

Do positive resection margins after ablative surgery for head and neck cancer adversely affect prognosis? A study of 352 patients with recurrent carcinoma following radiotherapy treated by salvage surgery.

Abstract

It is generally accepted by surgeons that failure to eradicate malignant disease at the primary site has an adverse effect on survival. The present study investigates 352 patients with squamous carcinoma of the head and neck treated by primary radical radiotherapy and who subsequently underwent surgical ablation for a recurrent carcinoma. A total of 303 (86%) patients had a negative resection margin and 49 (14%) had a positive resection margin. Oral carcinoma was 1.7 times more likely to be associated with a positive margin than other tumours (P = 0.0292). Actuarial calculations demonstrated that 47% of patients with negative margins and 66% of patients with positive margins developed a primary site recurrence (P = 0.0286). Neck node recurrence occurred in 10% of those patients with negative margins and 12% of patients with positive margins. Patients with positive margins had a significantly poorer survival than those with negative margins (P = 0.022). Multivariate analysis failed to confirm any independent adverse effect from a positive margin. The 5 year tumour-specific survival of patients with a positive margin was poorer by 12% than for those patients with a negative margin. The pattern of failure differed between the two groups, with patients having positive margins tending to die of local recurrence.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (836K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Bocca E, Pignataro O, Mosciaro O. Supraglottic surgery of the larynx. Ann Otol Rhinol Laryngol. 1968 Dec;77(6):1005–1026. [PubMed]
  • Byers RM, Bland KI, Borlase B, Luna M. The prognostic and therapeutic value of frozen section determinations in the surgical treatment of squamous carcinoma of the head and neck. Am J Surg. 1978 Oct;136(4):525–528. [PubMed]
  • Chen TY, Emrich LJ, Driscoll DL. The clinical significance of pathological findings in surgically resected margins of the primary tumor in head and neck carcinoma. Int J Radiat Oncol Biol Phys. 1987 Jun;13(6):833–837. [PubMed]
  • Cook JA, Jones AS, Phillips DE, Soler Lluch E. Implications of tumour in resection margins following surgical treatment of squamous cell carcinoma of the head and neck. Clin Otolaryngol Allied Sci. 1993 Feb;18(1):37–41. [PubMed]
  • Harrison DF. Role of surgery in the management of postcricoid and cervical esophageal neoplasms. Ann Otol Rhinol Laryngol. 1972 Aug;81(4):465–468. [PubMed]
  • Harrison D. The questionable value of total glossectomy. Head Neck Surg. 1983 Nov-Dec;6(2):632–638. [PubMed]
  • Looser KG, Shah JP, Strong EW. The significance of "positive" margins in surgically resected epidermoid carcinomas. Head Neck Surg. 1978 Nov-Dec;1(2):107–111. [PubMed]
  • Peto R, Pike MC, Armitage P, Breslow NE, Cox DR, Howard SV, Mantel N, McPherson K, Peto J, Smith PG. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples. Br J Cancer. 1977 Jan;35(1):1–39. [PMC free article] [PubMed]
  • Scholl P, Byers RM, Batsakis JG, Wolf P, Santini H. Microscopic cut-through of cancer in the surgical treatment of squamous carcinoma of the tongue. Prognostic and therapeutic implications. Am J Surg. 1986 Oct;152(4):354–360. [PubMed]
  • Veronesi U. How important is the assessment of resection margins in conservative surgery for breast cancer? Cancer. 1994 Sep 15;74(6):1660–1661. [PubMed]
  • Vikram B, Strong EW, Shah JP, Spiro R. Failure at the primary site following multimodality treatment in advanced head and neck cancer. Head Neck Surg. 1984 Jan-Feb;6(3):720–723. [PubMed]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...