{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:06:04Z","timestamp":1792803964982,"version":"4.5.0"},"reference-count":23,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T00:00:00Z","timestamp":1655424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Department of Otolaryngology Head and Neck Surgery, the Catholic University of Korea","award":["5-2021-B0001-00043"],"award-info":[{"award-number":["5-2021-B0001-00043"]}],"id":[{"id":"https:\/\/ror.org\/01fpnj063","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Department of Otolaryngology Head and Neck Surgery, the Catholic University of Korea","award":["NRF-2021R1C1C1004073"],"award-info":[{"award-number":["NRF-2021R1C1C1004073"]}],"id":[{"id":"https:\/\/ror.org\/01fpnj063","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Korean government","award":["5-2021-B0001-00043"],"award-info":[{"award-number":["5-2021-B0001-00043"]}]},{"name":"Korean government","award":["NRF-2021R1C1C1004073"],"award-info":[{"award-number":["NRF-2021R1C1C1004073"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Introduction. Mucosal margins exhibit a mean shrinkage of 30\u201340% after resection of oral and oropharyngeal cancers, and an adequate in situ surgical margin frequently results in a pathological close margin. However, the impact on prognosis remains unclear. We investigated the impact of a pathological close margin on disease-free survival (DFS) and overall survival (OS). Methods. We retrospectively reviewed the clinicopathological data of 418 patients diagnosed with squamous cell carcinomas of the oral cavity or oropharynx who underwent initial surgery (with curative intent) at our institute between 2010 and 2016. Results. Of the total population, the pathological marginal status of 290 (69.4%) patients was reported as clear (&gt;5 mm), 61 (14.6%) as close (&gt;1 mm, \u22645 mm), and 67 (16.0%) as positive (\u22641 mm). The 5-year DFSs were 79.3%, 65.1%, and 52% in patients in the negative margin (group 1), close margin (group 2), and positive margin (group 3) groups, respectively. The difference between groups 1 and 2 was not significant (p = 0.213) but the difference between groups 2 and 3 was (p = 0.034). The 5-year OSs were 79.4%, 84%, and 52.3% in groups 1, 2, and 3, respectively. The difference between groups 1 and 2 was not significant (p = 0.824) but the difference between groups 2 and 3 was (p = 0.001). In multivariate analysis, older age, advanced T stage, and a positive margin were independently prognostic of the 5-year DFS and OS. Conclusion. In conclusion, the OS of patients with close margins was no different than that of others when appropriate postoperative adjuvant and\/or salvage treatment were\/was prescribed. However, we could not determine the impact of close margins on locoregional recurrence given various biases in our study setting. A future prospective study is needed.<\/jats:p>","DOI":"10.3390\/cancers14122990","type":"journal-article","created":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T11:45:44Z","timestamp":1655466344000},"page":"2990","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Close Surgical Margins in Oral and Oropharyngeal Cancer: Do They Impact Prognosis?"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4049-2823","authenticated-orcid":false,"given":"Dong-Hyun","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Catholic University College of Medicine, Seoul 21431, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geun-Jeon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Catholic University College of Medicine, Seoul 21431, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1802-8952","authenticated-orcid":false,"given":"Hyun-Bum","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Catholic University College of Medicine, Seoul 21431, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun-Il","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Catholic University College of Medicine, Seoul 21431, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9551-9571","authenticated-orcid":false,"given":"Choung-Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Catholic University College of Medicine, Seoul 21431, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inn-Chul","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Catholic University College of Medicine, Seoul 21431, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung-Hae","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Catholic University College of Medicine, Seoul 21431, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1158-0974","authenticated-orcid":false,"given":"Young-Hoon","family":"Joo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Catholic University College of Medicine, Seoul 21431, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwang-Jae","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Catholic University College of Medicine, Seoul 21431, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Il","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Catholic University College of Medicine, Seoul 21431, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young-Hak","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Catholic University College of Medicine, Seoul 21431, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7118-3463","authenticated-orcid":false,"given":"Jun-Ook","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Catholic University College of Medicine, Seoul 21431, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1034\/j.1601-0825.2003.01750.x","article-title":"Sites of recurrence in oral and oropharyngeal cancers according to the treatment approach","volume":"9","author":"Carvalho","year":"2003","journal-title":"Oral Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1016\/j.oraloncology.2005.06.008","article-title":"A histopathological appraisal of surgical margins in oral and oropharyngeal cancer resection specimens","volume":"41","author":"Woolgar","year":"2005","journal-title":"Oral Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.6004\/jnccn.2014.0142","article-title":"Head and neck cancers, Version 2.2014. Clinical practice guidelines in oncology","volume":"12","author":"Pfister","year":"2014","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1016\/S0002-9610(05)80555-0","article-title":"Significance of positive margins in oral cavity squamous carcinoma","volume":"160","author":"Loree","year":"1990","journal-title":"Am. J. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1002\/hed.20279","article-title":"Defining risk levels in locally advanced head and neck cancers: A comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (#9501)","volume":"27","author":"Bernier","year":"2005","journal-title":"Head Neck"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1054\/ijom.2002.0262","article-title":"Do frozen sections help achieve adequate surgical margins in the resection of oral carcinoma?","volume":"32","author":"Ribeiro","year":"2003","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/j.tripleo.2008.11.013","article-title":"What is the adequate margin of surgical resection in oral cancer?","volume":"107","author":"Nason","year":"2009","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1002\/lary.23900","article-title":"Margin mapping in transoral surgery for head and neck cancer","volume":"123","author":"Hinni","year":"2013","journal-title":"Laryngoscope"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1001\/jamaoto.2016.4238","article-title":"A Proposal to Redefine Close Surgical Margins in Squamous Cell Carcinoma of the Oral Tongue","volume":"143","author":"Zanoni","year":"2017","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1001\/jamaoto.2017.0548","article-title":"Definition of \u201cClose Margin\u201d in Oral Cancer Surgery and Association of Margin Distance with Local Recurrence Rate","volume":"143","author":"Tasche","year":"2017","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"104883","DOI":"10.1016\/j.oraloncology.2020.104883","article-title":"Impact of 3 mm margin on risk of recurrence and survival in oral cancer","volume":"110","author":"Brinkman","year":"2020","journal-title":"Oral Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1016\/j.oraloncology.2006.10.001","article-title":"The clinical significance of the positive surgical margin in oral cancer","volume":"43","author":"Binahmed","year":"2007","journal-title":"Oral Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1002\/(SICI)1097-0347(199707)19:4<281::AID-HED6>3.0.CO;2-X","article-title":"Quantification of surgical margin shrinkage in the oral cavity","volume":"19","author":"Johnson","year":"1997","journal-title":"Head Neck"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1002\/micr.22275","article-title":"Effects of radiation therapy on postoperative complications and adverse events in patients with head and neck reconstruction with flaps","volume":"34","author":"Onoda","year":"2014","journal-title":"Microsurgery"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1016\/j.jamcollsurg.2015.06.011","article-title":"Prediction of Postoperative Complications Using Multidimensional Frailty Score in Older Female Cancer Patients with American Society of Anesthesiologists Physical Status Class 1 or 2","volume":"221","author":"Choi","year":"2015","journal-title":"J. Am. Coll. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1016\/j.jamcollsurg.2010.01.028","article-title":"Frailty as a predictor of surgical outcomes in older patients","volume":"210","author":"Makary","year":"2010","journal-title":"J. Am. Coll. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1001\/jamasurg.2014.241","article-title":"Multidimensional frailty score for the prediction of postoperative mortality risk","volume":"149","author":"Kim","year":"2014","journal-title":"JAMA Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1093\/ageing\/afx166","article-title":"What is Comprehensive Geriatric Assessment (CGA)? An umbrella review","volume":"47","author":"Parker","year":"2018","journal-title":"Age Ageing"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1007\/s12105-019-01047-9","article-title":"Practical Challenges in Measurement of Depth of Invasion in Oral Squamous Cell Carcinoma: Pictographical Documentation to Improve Consistency of Reporting per the AJCC 8th Edition Recommendations","volume":"14","author":"Kukreja","year":"2020","journal-title":"Head Neck Pathol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1007\/s11604-020-00982-w","article-title":"Radiological approach for the newly incorporated T staging factor, depth of invasion (DOI), of the oral tongue cancer in the 8th edition of American Joint Committee on Cancer (AJCC) staging manual: Assessment of the necessity for elective neck dissection","volume":"38","author":"Baba","year":"2020","journal-title":"Jpn. J. Radiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1002\/lary.26890","article-title":"Positive fresh frozen section margins as an adverse independent prognostic factor for local recurrence in oral cancer patients","volume":"128","author":"Szewczyk","year":"2018","journal-title":"Laryngoscope"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1002\/hed.24779","article-title":"Endocavitary sonography of early oral cavity malignant tumors","volume":"39","author":"Angelelli","year":"2017","journal-title":"Head Neck"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1007\/s10103-019-02932-z","article-title":"Early tongue carcinomas (clinical stage I and II): Echo-guided three-dimensional diode laser mini-invasive surgery with evaluation of histological prognostic parameters. A study of 85 cases with prolonged follow-up","volume":"35","author":"Limongelli","year":"2020","journal-title":"Lasers Med. Sci."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/14\/12\/2990\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:33:53Z","timestamp":1760139233000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/14\/12\/2990"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,17]]},"references-count":23,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["cancers14122990"],"URL":"https:\/\/doi.org\/10.3390\/cancers14122990","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,17]]}}}