Prognostic factors
Our series identified positive excision margins as predictive factor for tumour recurrence after TR (p=0.0401). This reiterates the importance of complete tumour excision with sufficiently clear margins. In cases of involved margins, considerations should be made for further surgical resection and the use of adjuvant treatment. To our knowledge, only one similar study found statistically significant factors predictive for recurrence i.e., better local control and DSS in case of clear margins, and better regional control in cases of bilateral neck prophylactic treatment (13). On multivariate analysis, they also observed that R1 or R2 margins were associated with a poorer DFS, despite this not reaching statistical significance (13).
In our series, there was no correlation between the risk of tumour recurrence and the Wang classification (p>0.9999), clinical T stage (p>0.9999) and pathological T stage of 8th edition of AJCC for tumours of the nasal cavity (p=0.2898). Several other series of vestibule SCCs emphasised the absence of association between rates of recurrence and the Wang or AJCC classification (8,9). However, the population-based study by Agger et al. including 174 vestibule SCCs found a significant association between DSS and the Wang classification (2). Controversy remains regarding the accuracy of the current staging classifications available for vestibule SCCs (8), whilst further series may help to develop more appropriate and specific staging systems.