Abstract
Tongue leukoplakia （TL） is often histopathologically diagnosed as squamous cell carcinoma （SCC） after resection. In cases where the resection margins are close, additional resection is often considered. However, there is no clear consensus on the significance of an additional resection. The present study aimed to clarify the treatment outcomes and effectiveness of an additional resection.
This retrospective study involved a clinical chart review of 29 cases of patients with TL on clinical presentation, with a histopathological diagnosis of SCC, who were treated at the Department of Oral Surgery, Nagasaki University Hospital, between June 2008 and March 2021. Data was collected, and the treatment outcomes and significance of the additional resections were analyzed.
Four patients （13.8％） had local recurrence, and three （10.3％） had delayed cervical lymph node metastasis. The cumulative local recurrence rate was significantly different between the two groups （＜3 mm vs ≥3 mm）, with a cut-off value of 3 mm at the horizontal transecting distance （p＝0.012）. The local recurrence rate was not significantly different between patients who underwent additional resections and those who underwent observation when the horizontal margins were less than 3 mm. Additional resections did not contribute to the decrease in the local recurrence rate. Univariate analysis showed significant differences in the pathological depth of invasion （pDOI） （p＝0.038） and mode of invasion （p＝0.026） in cases of delayed cervical lymph node metastasis, while multivariate analysis did not.
Horizontal margins of less than 3 mm may be useful in determining whether additional resection is necessary.
