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CC BY-NC-ND 4.0 · South Asian J Cancer 2020; 09(01): 34-37
DOI: 10.4103/sajc.sajc_366_18
ORIGINAL ARTICLE: Head and Neck Cancers

Adequacy of surgical margins in oral cancer patients with respect to various types of reconstruction

Apurva Garg
Department of Head and Neck Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
,
Manish Mair
Department of Head and Neck Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
,
Hitesh Singhavi
Department of Head and Neck Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
,
Muddasir Bhati
Department of Head and Neck Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
,
Akshat Malik
Department of Head and Neck Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
,
Aseem Mishra
Department of Head and Neck Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
,
Deepa Nair
Department of Head and Neck Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
,
Sudhir Nair
Department of Head and Neck Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
,
Pankaj Chaturvedi
Department of Head and Neck Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
› Author Affiliations Financial support and sponsorship: Nill.
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Abstract

Bacground: Surgical margin is an important prognostic factor for oral cancers (oral squamous cell carcinoma [OSCC]). The correlation of margin with the type of reconstruction has never been studied. Aim: This study aimed to correlate surgical margins with the type of reconstruction. Methods: This was a retrospective study of 410 treatment-naïve OSCC patients. As per the methods of reconstruction, three groups were made when reconstruction was performed using pedicled flap (PF) or local flap, free flap, and primary closure (PC). Statistical Analysis: Chi-square test was used for comparison of margin status as per the method of reconstruction. Mann–Whitney test was used to find the difference between the mean margin width with respect to the type of reconstruction. Results: The overall incidence of close/positive margins was 7.8%. The incidence of close/positive margins was not significantly different in free flap group compared to PF (P = 0.06) or PC (P = 0.835) group. However, there was a significant difference in the incidence of close/positive margins between PC and PF groups (P = 0.021). Whether the reconstruction is performed by the primary surgeon or by a another surgeon, it did not have an impact on adequacy of margins (P = 0.334). Margins were wider when the reconstruction is performed by a different team (P = 0.015) or when reconstruction is performed as compared to PC. Conclusion: Margins are not affected by the type of reconstruction (pedicled vs. free flap) and the team doing reconstruction (same vs. another team). Margins are significantly compromised when a surgeon performs PC himself/herself compared to PF.

Key words

Free flap - margins - oral cancers - primary closure - reconstruction


Publication History

Article published online:
14 December 2020

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