Preoperative Predictors of Close or Compromised Surgical Margins in Patients With Oral Squamous Cell Carcinoma.

Abstract

Clear surgical margins are crucial for oral cancer (OSCC) patients' prognosis. The rising incidence of close or compromised margins (CCM) is a significant concern. This study aimed to identify preoperative and post-operative predictors of CCM in OSCC. We conducted a retrospective analysis of 1913 treatment-naïve OSCC patients treated at a single institution. Clinical, radiological, and pathological data were collected, with CCM defined as ≤ 5 mm. Statistical analyses included logistic regression and recursive partitioning models. We included 1913 patients with 197 (10.5%) exhibiting CCM. Preoperative predictors associated with the risk of CCM included the use of physical examination alone for staging, cT3-4 classification, and single-team approach for resection and reconstruction. These preoperative features, together with bone invasion and worst pattern of invasion, were significant in the post-operative setting. Effective preoperative staging and a two-team surgical approach increase the likelihood of obtaining clear surgical margins in patients with OSCC and should be pursued in the preoperative setting. Pathological features like bone invasion and worst pattern of invasion (WPOI) allow for the stratification of patients at higher risk for CCM.