A meta-analysis of margin size and local recurrence in oral squamous cell carcinoma

SummaryObjectives: Excision margins for oral squamous cell carcinoma (OSCC) are poorly understood. Close (<5 mm) and involved (<1 mm) pathological margins are key indicators of the need for adjuvant treatment. This review aimed to assess the impact of pathological margin size on local recurrence rates.Methods: MEDLINE and EMBASE were searched for studies that looked at local recurrence following excision of primary OSCC without adjuvant therapy. Five studies met the inclusion criteria.Results: Recurrence rates were pooled to give a 21% absolute risk reduction (95% confidence interval 12-30%, p =< 0.00001) in local recurrence with margins clear by more than 5 mm. Unweighted pooled recurrence rates were 20% in patients with margins clear by more than 5 mm.Conclusion: These findings suggest that a 5 mm pathological margin is the minimum acceptable margin size in OSCC.