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Background <p>Oral squamous cell carcinoma (OSCC) refers to a prevalent cancer in the neck and head region, with poor prognosis and a high risk of recurrence after surgery. Surgical margin (SM) and the margin to depth of invasion ratio (MDR) are critical factors influencing survival outcomes. Currently, the impact of SM width and MDR on prognosis remains controversial. This study seeks to systematically compare the predictive value of SM width and MDR for OSCC prognosis, providing evidence for optimizing SM evaluation standards.</p> Methods <p>We systematically searched PubMed, Web of Science, Embase, and Cochrane Library for relevant studies from database inception to April 1, 2026. Two researchers separately reviewed the included studies and extracted the data. The quality of the included studies was assessed using the Quality In Prognosis Studies (QUIPS) tool. Meta-analysis was carried out via STATA 18.0 software, and the related summary plots were generated.</p> Results <p>A total of 41 studies involving 61,863 individuals were included. A poor SM was significantly associated with unfavorable overall survival (OS) (HR = 1.56, 95% CI 1.37–1.77, <i>p</i> &lt; 0.001), disease-free survival (DFS) (HR = 1.72, 95% CI 1.29–2.28, <i>p</i> &lt; 0.001), and recurrence-free survival (RFS) (HR = 1.99, 95%CI 1.53–2.58, <i>p</i> &lt; 0.001). A low margin to depth of invasion ratio (MDR) was significantly associated with worse OS (HR = 1.36, 95% CI 1.21–1.54, <i>p</i> &lt; 0.001) and DFS (HR = 1.40, 95% CI 1.12–1.74, <i>p</i> = 0.003). Subgroup analysis demonstrated that these associations might be influenced by different cutoff values, data analysis sources, and geographical factors.</p> Conclusion <p>This study revealed significant associations between SM, MDR, and the OSCC prognosis. Nevertheless, the clinical value of these indicators may be affected by variability in cutoff values across studies. Future large-scale, multicenter prospective studies are required to validate these findings and further investigate the prognostic impact of varying cutoff values.</p>

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Prognostic value of surgical margin and margin to depth of invasion ratio in oral squamous cell carcinoma: a meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月3日

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  • Jin Xu,
  • Qian Cui,
  • Yinqi Chen,
  • Wenyuan Yu,
  • Yong Xu,
  • Yu Shao,
  • Zhonghao Liu,
  • Zhenggang Chen

摘要

Background

Oral squamous cell carcinoma (OSCC) refers to a prevalent cancer in the neck and head region, with poor prognosis and a high risk of recurrence after surgery. Surgical margin (SM) and the margin to depth of invasion ratio (MDR) are critical factors influencing survival outcomes. Currently, the impact of SM width and MDR on prognosis remains controversial. This study seeks to systematically compare the predictive value of SM width and MDR for OSCC prognosis, providing evidence for optimizing SM evaluation standards.

Methods

We systematically searched PubMed, Web of Science, Embase, and Cochrane Library for relevant studies from database inception to April 1, 2026. Two researchers separately reviewed the included studies and extracted the data. The quality of the included studies was assessed using the Quality In Prognosis Studies (QUIPS) tool. Meta-analysis was carried out via STATA 18.0 software, and the related summary plots were generated.

Results

A total of 41 studies involving 61,863 individuals were included. A poor SM was significantly associated with unfavorable overall survival (OS) (HR = 1.56, 95% CI 1.37–1.77, p < 0.001), disease-free survival (DFS) (HR = 1.72, 95% CI 1.29–2.28, p < 0.001), and recurrence-free survival (RFS) (HR = 1.99, 95%CI 1.53–2.58, p < 0.001). A low margin to depth of invasion ratio (MDR) was significantly associated with worse OS (HR = 1.36, 95% CI 1.21–1.54, p < 0.001) and DFS (HR = 1.40, 95% CI 1.12–1.74, p = 0.003). Subgroup analysis demonstrated that these associations might be influenced by different cutoff values, data analysis sources, and geographical factors.

Conclusion

This study revealed significant associations between SM, MDR, and the OSCC prognosis. Nevertheless, the clinical value of these indicators may be affected by variability in cutoff values across studies. Future large-scale, multicenter prospective studies are required to validate these findings and further investigate the prognostic impact of varying cutoff values.