A 55-year-old male undergoes wide local excision of a T2N0M0 squamous cell carcinoma of the oral tongue. Final histopathology reveals a closest surgical margin of 1.2 mm. According to standard guidelines, what is the significance of this finding?
- A It is considered an adequate margin, no further treatment needed
- B It mandates immediate re-excision regardless of adjuvant therapy planned
- C It is considered a close margin, associated with increased local recurrence risk ✓
- D It is considered a positive margin requiring adjuvant chemotherapy alone
Correct answer: C. It is considered a close margin, associated with increased local recurrence risk
Explanation
A surgical margin of less than 5 mm is generally considered a close margin in oral cavity squamous cell carcinoma and is associated with a significantly increased risk of local recurrence. Standard guidelines recommend adjuvant radiotherapy (or re-resection when feasible) for close margins. A positive margin is defined as tumor at the inked surface (0 mm). Margins greater than 5 mm are considered adequate.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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