Clinical Oral Investigations

, Volume 22, Issue 4, pp 1625–1630 | Cite as

Anatomical locations in the oral cavity where surgical resections of oral squamous cell carcinomas are associated with a close or positive margin—a retrospective study

  • Florian Alexander Kerker
  • Werner Adler
  • Kathrin Brunner
  • Tobias Moest
  • Matthias C. Wurm
  • Emeka Nkenke
  • Friedrich Wilhelm Neukam
  • Cornelius von WilmowskyEmail author



This study aimed to identify anatomical areas where resections of oral squamous cell carcinomas (OSCC) are significantly associated with close or positive margins.

Materials and methods

This retrospective study included 330 patients with a primary OSCC from 2010 to 2015. Patient and tumour data were categorised into three groups by R-status (R0 [clear], ≥ 5 mm, 185 patients [56.06%]; R1 [positive], < 1 mm, 24 patients [7.27%]; and R0 [close], 1–5 mm, 121 patients [36.67%]).


Areas where resections were significantly associated with close or positive margins were the hard palate (p < 0.001), buccal mucosa (p = 0.03), floor of the mouth (p = 0.004), lower alveolar ridge (p = 0.01), retromolar triangle (p = 0.005), and dorsal tongue (p = 0.02).


Anatomical areas were identified in the oral cavity where it is challenging to resect OSCCs with an adequate safety margin.

Clinical relevance

These results may enable surgeons to achieve a postulated safe distance during tumour resection, leading to a survival benefit for patients.


Oral squamous cell carcinoma Resection margin R-status Anatomical areas Safety distance 



This work was funded by the “Verein zur Förderung des Tumorzentrums der Universität Erlangen-Nürnberg e.V.” (KC 35412066).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Florian Alexander Kerker
    • 1
  • Werner Adler
    • 2
  • Kathrin Brunner
    • 3
  • Tobias Moest
    • 1
  • Matthias C. Wurm
    • 1
  • Emeka Nkenke
    • 4
  • Friedrich Wilhelm Neukam
    • 1
  • Cornelius von Wilmowsky
    • 1
    Email author
  1. 1.Department of Oral and Maxillofacial SurgeryUniversity of Erlangen-NürnbergErlangenGermany
  2. 2.Department of Medical Informatics, Biometry and EpidemiologyUniversity of Erlangen-NürnbergErlangenGermany
  3. 3.Department of PathologyUniversity of Erlangen-NürnbergErlangenGermany
  4. 4.Department of Cranio-, Maxillofacial and Oral SurgeryMedical University of ViennaViennaAustria

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