PREOPERATIVE FACTORS PREDICTING CLOSE/POSITIVE SURGICAL MARGINS IN ORAL CARCINOMA: A RETROSPECTIVE STUDY parijatsuryavanshi@gmail.com

 

PREOPERATIVE FACTORS PREDICTING CLOSE/POSITIVE SURGICAL MARGINS IN ORAL CARCINOMA: A RETROSPECTIVE STUDY

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India

Oral or Poster

Achieving clear surgical margins is crucial in treating oral squamous cell carcinoma (OSCC), influencing prognosis, recurrence, and survival. This retrospective study aimed to identify preoperative clinical and pathological factors that influence surgical margin status, thereby enhancing patient stratification and improving oncologic outcomes

We retrospectively analysed 120 OSCC patients who underwent surgery at King George's Medical University, Lucknow, in 2021- 2025. Data on tumour site, differentiation, thickness, depth (DOI), lymphovascular and perineural invasion (LVI/PNI), tumour-infiltrating lymphocytes (TILs), skin and bone involvement, and T and N stages were collected and correlated with surgical margin status. DFS rates and rates of recurrence were also compared across margin groups.

Most patients were middle-aged males, with tumours frequently located in the buccal mucosa and tongue. Well-differentiated tumours predominated, and 76.7% had negative margins, 22.5% had close margins, and 0.8% had positive margins. Recurrence was significantly higher in close-margin cases (33.3% vs. 10.8%; p = 0.001), correlating with shorter mean disease-free survival (244.8 vs. 600.5 days; p < 0.001). Female sex and skin involvement emerged as independently significant factors associated with a higher incidence of close margins (p = 0.001, p = 0.008).

This study identifies skin involvement and female gender as significant preoperative indicators for close or positive surgical margins, emphasising their importance in surgical planning for OSCC. The profound impact of margin status on recurrence and DFS underscores the necessity of achieving clear margins through meticulous preoperative assessment, tailored surgical approaches, and intraoperative margin control to improve patient outcomes.