OBJECTIVES To find out the role of resection margin involvement in surgically managed HPV-positive tonsil cancer. MATERIALS AND METHODS The study included 94 subjects with HPV-positive tonsil cancer undergoing surgical treatment. We evaluated the relationships between the resection margin status, clinicopathological factors, and oncological outcome. RESULTS The rate of resection margin involvement was 22.3% (21/94) after ablative surgery. Margin involvement, lymphatic invasion, and extracapsular spread were associated with the 5-year disease-free survival (DFS) and disease-specific survival (DSS) rate in univariate analysis. Multivariate Cox regression analysis confirmed a significant association between the margin involvement and 5-year DFS rate (HR = 4.602; 95% CI = 1.202-17.620; p = 0.026) and 5-year DSS rate (HR = 12.826; 95% CI = 1.399-117.593; p = 0.024). The incidence of resection margin involvement was significantly higher in patients with larger tumors (35.19 ± 15.07 mm vs. 25.53 ± 10.32 mm, p = 0.011) and more invasive tumors (17.84 ± 7.90 mm vs. 13.46 ± 6.88 mm, p = 0.037). The cutoff value of tumor size and depth of invasion for resection margin involvement was 29.5 mm (74% sensitivity and 63% specificity) and 14.5 mm (74% sensitivity and 61% specificity), respectively. CONCLUSION Resection margin involvement was significantly correlated with tumor size and the depth of invasion in HPV-positive tonsil cancer. Furthermore, resection margin involvement was associated with adverse outcomes.

中文翻译：

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手术控制的HPV阳性扁桃体癌的切除边缘受累对预后的影响。

目的探讨在手术控制的HPV阳性扁桃体癌中切除切缘受累的作用。材料与方法该研究纳入了接受手术治疗的94例HPV阳性扁桃体癌患者。我们评估了切除切缘状态，临床病理因素和肿瘤学结局之间的关系。结果消融手术后切除切缘受累率为22.3％（21/94）。在单变量分析中，边缘受累，淋巴管浸润和囊外扩散与5年无病生存率（DFS）和疾病特异性生存率（DSS）相关。多元Cox回归分析证实了边缘介入与5年DFS率（HR = 4.602; 95％CI = 1.202-17.620; p = 0.026）和5年DSS率（HR = 12.826; 95％CI = 1.399-117。593; p = 0.024）。肿瘤较大的患者（35.19±15.07 mm vs. 25.53±10.32 mm，p = 0.011）和更具浸润性的肿瘤（17.84±7.90 mm vs. 13.46±6.88 mm，p = 0.037）的患者切缘受累发生率明显更高。切除范围累及的肿瘤大小和浸润深度的临界值分别为29.5 mm（敏感性74％和63％特异性）和14.5 mm（敏感性74％和61％特异性）。结论切除边缘受累与HPV阳性扁桃体癌的肿瘤大小和浸润深度显着相关。此外，切除边缘受累与不良预后相关。011）和更具侵袭性的肿瘤（17.84±7.90 mm对13.46±6.88 mm，p = 0.037）。切除范围累及的肿瘤大小和浸润深度的临界值分别为29.5 mm（敏感性74％和63％特异性）和14.5 mm（敏感性74％和61％特异性）。结论切除边缘受累与HPV阳性扁桃体癌的肿瘤大小和浸润深度显着相关。此外，切除边缘受累与不良预后相关。011）和更具侵袭性的肿瘤（17.84±7.90 mm对13.46±6.88 mm，p = 0.037）。切除范围累及的肿瘤大小和浸润深度的临界值分别为29.5 mm（敏感性74％和63％特异性）和14.5 mm（敏感性74％和61％特异性）。结论切除边缘受累与HPV阳性扁桃体癌的肿瘤大小和浸润深度显着相关。此外，切除边缘受累与不良预后相关。结论切除边缘受累与HPV阳性扁桃体癌的肿瘤大小和浸润深度显着相关。此外，切除边缘受累与不良预后相关。结论切除边缘受累与HPV阳性扁桃体癌的肿瘤大小和浸润深度显着相关。此外，切除边缘受累与不良预后相关。