Resection margins and other prognostic factors in the carcinoma of the oral cavity, oro-hypopharynx and larynx: a multicenter, prospective, multi-outcome, three-years follow-up study

BACKGROUND: The resection margins and their prognostic significance are still subject of conflicting opinions. This paper is aimed to update our previous study with a more adequate follow-up, and to evaluate a stratification into risk categories and effectiveness of adjuvant treatment.METHODS: A prospective study, carried out between 2015 and 2018 with the participation of 10 reference hospitals. The primary objective was evaluating local control.RESULTS: Four hundred fifty-four enrolled patients had a minimum follow-up of three years. The previous treatment, fresh specimen evaluation and nearest microscopic margin (mm) on the specimen, were risk factors in the multivariate analysis for local control. Risk classes are delineated for the different oncological outcomes. The prognostic significance of the margins is confirmed; other factors emerge as risk profiles, which would require diversified treatments and follow-up.CONCLUSIONS: Infiltrated margins appear characteristic of a more aggressive disease, sometimes preoperatively identifiable. Adjuvant therapy and collaboration with the pathologist are able to improve the results.