COMPARATIVE STUDY ON SURGICAL MARGINS AND RECURRENCE RATE IN ORAL CANCER: A PROSPECTIVE OBSERVATIONAL STUDY

Background: Surgical margin status is a pivotal determinant of recurrence and survival outcomes in oral squamous
cell carcinoma. However, the clinical implications of close and involved margins remain under critical evaluation.
This prospective observational study intended to scrutinize influence of histopathologically stratified surgical margins
on recurrence patterns and recurrence-free survival in patients with OSCC.
Methods: 90 treatment-naïve patients with T1–T3 primary OSCC were prospectively registered and grouped based
on final margin status: Group A (clear margins ≥5 mm), Group B (close margins 1–4.9 mm), and Group C (involved
margins <1 mm or tumor on ink). All underwent wide local excision with or without neck dissection. Follow-up
evaluations were conducted over 24 months, and recurrence data were analyzed using Chi-square testing, Kaplan–
Meier survival examined, and multivariate Cox regression modeling.
Results: Locoregional recurrence occurred in 28 patients: 26.7% in Group A, 30.0% in Group B, and 36.7% in Group
C (p = 0.53). Kaplan–Meier analysis showed a progressive decline in 24-month RFS (81.2%, 68.1%, and 55.4%,
respectively). Multivariate Cox regression identified involved margins (HR = 3.21, p = 0.001) and perineural invasion
(HR = 2.15, p = 0.028) as independent predictors of recurrence.
Conclusion: Margin status significantly influences recurrence risk and RFS in OSCC. Even close margins confer
elevated recurrence hazards, highlighting the need for precise intraoperative margin clearance and incorporation of
histopathological risk factors into postoperative planning.