Background and Objectives : Positive resection margins following primary surgical treatment for squamous cell carcinoma of the head and neck (HNSCC) is thought to adversely affect prognosis. There is a controversy over which postoperative
managements is more effective for these patients. The purpose of this study is to verify our postoperative treatment plan.
Materials and Methods : From January 1992 to December 1996, 412 HNSCC patients were treated with surgery at Korea University Hospital. Pathologic review of these cases identified 16 patients with positive resection margins. The anatomic subsites of primary cancers included supraglottis (n=7), glottis (n=2), oral tongue (n=2), hypopharynx (n=4), and maxilla (n=1). Postoperative radiotherapy alone was performed in 4 of these patients, and administration of UFT alone was done in 1 of them, while the combination of these two treatment modalities was instituted for the rest of the patients. The median radiation dose was 6840 cGy. The dose of UFT (Tegafur and Uracil complex) was 400 mg/㎡ a day for 6 momths.
Results : After the postoperative management, there were 6 patients in the NED group (37.5%), 3 in the locoregional recurrence group (18.8%), and seven in the survival rate was 25%.
Conclusion : For satisfactory treatment, the operation should be designed to minimize likelihood of residual tumor at the resection margins. We conclude that improved local control can be achieved with postoperative radiotherapy with or without UFT in patients with positive resection margin.
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