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McMahon J, O'Brien CJ et al. Br J Oral Maxillofac Surg 2003; 41: 224–231

Some authorities have recommended excision margins of >1 cm for these tumours, but wide margins increase functional impairment. In this study 332 patients treated at 2 centres with identical protocols were followed up for a minimum 1 year (around 4/5 of recurrence is within 2 yrs). Depending on diagnostic findings, comprehensive neck dissection and/or radiotherapy was added to the basic surgical procedure aimed at 1 cm margins. Follow-up was >2 yrs for 177 patients.

Local recurrence occurred in 48 patients, nodal recurrence in 32, and distant metastasis in 24. Univariate analysis showed a wide range of factors predicting local recurrence including the condition of excision margins, but multivariate analysis identified only the presence and extent of regional nodal involvement as an independent predictor of disease-specific survival. The authors advise 1 cm margins as adequate, and consider that other factors have greater effects on recurrence.