Association of the Specimen and Tumor Bed Margin Status with Local Recurrence and Survival in Open Partial Laryngectomy
Background/Objectives: Positive margins are associated with locoregional recurrence in early laryngeal cancer. The aim of this study was to evaluate the impacts of specimen-driven (ex vivo) positive margins on patients with early-stage laryngeal cancer whose tumor bed (defect-driven) margins had been negative. Methods: A retrospective study was performed on 60 consecutive T1b/T2 glottic cancer patients who underwent open frontolateral laryngectomy. The intraoperative margins were obtained from the tumor bed. Their recurrence and disease-free survival were evaluated. In all cases, negative margins were obtained from the surgical bed. The impact of positive margins from the specimen was evaluated in a paraffin study. Results: Among 10 patients with positive margins in the specimen, six experienced local relapse, and among 50 patients with negative margins in the specimen, three developed recurrence. The 5-year disease-free survival rates were 37.5% and 93.9%, respectively (p textless 0.001; log-rank). Even with negative margins in the surgical bed, patients with positive margins in the specimen at the final histopathological examination had a 3.5-fold higher chance of developing local recurrence than those with negative margins (HR = 13.993; 95% CI: 3.479–56.281; p textless 0.001; univariate Cox regression). Conclusions: Specimen-driven positive margins represent a significant risk factor for local recurrence, even under negative margins at the tumor bed.
Citação
@online{rogério_aparecido2024,
author = {Rogério Aparecido , Dedivitis and Matos, Leandro Luongo, De
and Castro, Mario Augusto Ferrari, De and Luiz Paulo , Kowalski},
title = {Association of the Specimen and Tumor Bed Margin Status with
Local Recurrence and Survival in Open Partial Laryngectomy},
volume = {13},
number = {9},
date = {2024-04-24},
doi = {10.3390/jcm13092491},
langid = {pt-BR},
abstract = {Background/Objectives: Positive margins are associated
with locoregional recurrence in early laryngeal cancer. The aim of
this study was to evaluate the impacts of specimen-driven (ex vivo)
positive margins on patients with early-stage laryngeal cancer whose
tumor bed (defect-driven) margins had been negative. Methods: A
retrospective study was performed on 60 consecutive T1b/T2 glottic
cancer patients who underwent open frontolateral laryngectomy. The
intraoperative margins were obtained from the tumor bed. Their
recurrence and disease-free survival were evaluated. In all cases,
negative margins were obtained from the surgical bed. The impact of
positive margins from the specimen was evaluated in a paraffin
study. Results: Among 10 patients with positive margins in the
specimen, six experienced local relapse, and among 50 patients with
negative margins in the specimen, three developed recurrence. The
5-year disease-free survival rates were 37.5\% and 93.9\%,
respectively (p textless 0.001; log-rank). Even with negative
margins in the surgical bed, patients with positive margins in the
specimen at the final histopathological examination had a 3.5-fold
higher chance of developing local recurrence than those with
negative margins (HR = 13.993; 95\% CI: 3.479–56.281; p textless
0.001; univariate Cox regression). Conclusions: Specimen-driven
positive margins represent a significant risk factor for local
recurrence, even under negative margins at the tumor bed.}
}