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.
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.
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DOI：
10.1038/bjc.1996.327
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发表时间：
1996-07
影响因子：
8.8
通讯作者：
Helliwell, TR
中科院分区：
文献类型：
--
作者：
Jones, AS;Hanafi, ZB;Nadapalan, V;Roland, NJ;Kinsella, A;Helliwell, TR
关键词：
外科医生普遍认为，原发部位的恶性病变不能根除对生存率有不利影响。本研究调查了352例头颈部鳞状细胞癌患者，这些患者接受了原发性根治性放疗，随后接受了复发癌手术消融。共303例（86%）患者切缘阴性，49例（14%）患者切缘阳性。口腔癌与阳性边缘相关的可能性是其他肿瘤的1.7倍（P = 0.0292）。精算计算表明，47%的患者与阴性边缘和66%的患者与阳性边缘发展的原发部位复发（P = 0.0286）。切缘阴性患者中10%发生颈淋巴结复发，切缘阳性患者中12%发生颈淋巴结复发。切缘阳性患者的生存率明显低于切缘阴性患者（P = 0.022）。多变量分析未能证实任何独立的不利影响，从积极的边缘。切缘阳性患者的5年肿瘤特异性生存率比切缘阴性患者低12%。两组的失败模式不同，切缘阳性的患者倾向于死于局部复发。
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.
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影响因子：
2.1
作者：
COOK, JA;JONES, AS;LLUCH, ES
通讯作者：
LLUCH, ES
影响因子：
3
作者：
SCHOLL, P;BYERS, RM;SANTINI, H
通讯作者：
SANTINI, H
DOI：
10.1002/hed.2890060303
发表时间：
1984-01-01
期刊：
HEAD & NECK SURGERY
影响因子：
--
作者：
VIKRAM, B;STRONG, EW;SPIRO, R
通讯作者：
SPIRO, R
影响因子：
8.8
作者：
Peto R;Pike MC;Armitage P;Breslow NE;Cox DR;Howard SV;Mantel N;McPherson K;Peto J;Smith PG
通讯作者：
Smith PG
DOI：
10.1016/0360-3016(87)90095-2
发表时间：
1987-06-01
影响因子：
7
作者：
CHEN, TY;EMRICH, LJ;DRISCOLL, DL
通讯作者：
DRISCOLL, DL