Abstract
Background: The effect of surgical margins on local recurrence in T1 glottic squamous cell carcinoma (GSCC) is unclear.
Objectives: To investigate the association between surgical margins and local recurrence of T1 GSCC patients with vertical partial laryngectomy (VPL).
Materials and methods: We retrospectively studied 117 T1 GSCC patients. Close and negative margins were estimated as distance <5 mm and ≥5 mm. The effect of surgical margins on local recurrence was evaluated. For patients with invasion not reaching muscular-layer, a threshold margin of 2 mm was detected.
Results: About 109 patients were exclusively treated by VPL and 8 patients received postoperative radiotherapy. In 109 cases, the posterolateral margins and shortest margins in recurrence group were both lower than no-recurrence group (p<.01). The ratios of posterolateral margin to average diameter, upper-lower diameter and internal-external diameter in recurrence group were also statistically lower (p<.05). A threshold margin of 2 mm showed statistical difference on recurrence in patients with invasion not reaching muscular-layer.
Conclusions and significance: Posterolateral margin is crucial for local recurrence in T1 GSCC patients treated by VPL. A shortest margin of ≥5 mm should be considered. For the patients with invasion not reaching the muscular-layer, a threshold of 2 mm is enough for safe margin.
Chinese abstract
背景:T1型声门鳞状细胞癌(GSCC)手术裕度对局部复发的影响尚不清楚。
目的:探讨T1型GSCC垂直向部分喉切除术(VPL)患者手术裕度与局部复发的关系。
材料与方法:回顾性研究117例T1型GSCC患者。近裕度和负裕度估计为<5 mm的距离和≥5 mm的距离。评估手术裕度对局部复发的影响。对于未扩展到肌层的患者, 检测到阈值裕度为2 mm。
结果:109例患者全部采用VPL治疗, 其中8例接受了术后放疗。109例中, 复发组的后外侧裕度和最短裕度均低于无复发组(P < 0.01)。复发组的后外侧裕度与平均直径、上下径和内外径的比值也较低(P < 0.05)。对于未扩展到肌层的患者, 阈值裕度2 mm显示复发的统计学差异。
结论与意义:后外侧裕度对经VPL治疗的T1型GSCC患者的局部复发至关重要。应考虑至少5 mm的最短裕度。对于未扩展到肌层的患者, 2 mm的阈值足以保证安全裕度。
Disclosure statement
The authors declare that they have no competing interests.