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
| Autor: | A R Kinsella, Andrew S. Jones, Timothy R. Helliwell, N. J. Roland, Z. Bin Hanafi, V. Nadapalan |
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| Rok vydání: | 1996 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty medicine.medical_treatment Salvage therapy Carcinoma medicine Humans Survival analysis Proportional Hazards Models Salvage Therapy business.industry Head and neck cancer Middle Aged Prognosis medicine.disease Combined Modality Therapy Survival Analysis Squamous carcinoma Surgery Radiation therapy Oncology Epidermoid carcinoma Head and Neck Neoplasms Resection margin Female Neoplasm Recurrence Local business Research Article Follow-Up Studies |
| Zdroj: | British Journal of Cancer |
| ISSN: | 1532-1827 0007-0920 |
| DOI: | 10.1038/bjc.1996.327 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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