association between local recurrence and surgical margins in vertical partial laryngectomy for T1 glottic squamous cell carcinoma
Yue Yang, Jian Zhou, Min Chen, Yi Fang, Lei Tao, Peijie He, show all
Received 17 Dec 2018, Accepted 28 Apr 2019, Published online: 24 May 2019
Download citation https://doi.org/10.1080/00016489.2019.1614664
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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。
Keywords: Surgical margins, local recurrence, T1 GSCC, vertical partial laryngectomy
Yue Yang, Jian Zhou, Min Chen, Yi Fang, Lei Tao, Peijie He, show all
Received 17 Dec 2018, Accepted 28 Apr 2019, Published online: 24 May 2019
Download citation https://doi.org/10.1080/00016489.2019.1614664
Select Language▼
Translator disclaimer
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。
Keywords: Surgical margins, local recurrence, T1 GSCC, vertical partial laryngectomy
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