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Table 2 Referral status and possible causes for residual/persistent OSCCs

From: Salvage surgery for patients with residual/persistent diseases after improper or insufficient treatment of oral squamous cell carcinoma: can we rectify these mistakes?

Referral status and possible causes Number (%)
Referral status
 Institutional referral 78 (75.7)
 Patient’s decision 25 (24.3)
Primary treatment center
 with low-volume oral cancer cases 74 (71.8)
 with high-volume oral cancer cases 29 (28.2)
Surgeon’s expertise
 Junior consultant 22 (21.4)
 Senior consultant 69 (67.0)
 Surgeons of nonrelated specialty 12 (11.7)
Age of patients
 <70 84 (81.6)
  ≥ 70 19 (18.4)
Comorbidities
 Yes 43 (41.7)
 No 60 (58.3)
Reports of intraoperative frozen section
 Yes 50 (48.5)
 No 53 (51.5)
Report completeness for primary margins
  ≤ 3 margins 47 (45.6)
 >3 margins 56 (54.4)
Clinical stage
 Early stage 23 (22.3)
 Late stage 80 (77.7)
Clinical diagnosis before primary surgery
 Correct 86 (83.5)
 Wrong 17 (16.5)
Biopsy before primary surgery
 Yes 79 (76.7)
 No 24 (23.3)
Time Lag between outpatient biopsy to primary admission*
  ≤ 2 month 63 (79.8)
  > 2 month 16 (20.2)
Patient’s initial reluctancy to radical resection/reconstruction
 Yes 41 (39.8)
 No 62 (60.2)
Treatment design mistakes&
 Flawed access for advanced cases 21 (20.4)
 Undertreatment regarding tumor depths 37 (35.9)
 Mismatch between imaging sizes and resection methods 32 (31.1)
 None of the above 41 (39.8)
Unstandardized operative implementations&
 Residual positive lymph node in operated cervical basin 24 (23.3)
 Non-enbloc resection for advanced lesions 11 (10.7)
 None of the above 78 (75.7)
  1. *: Only patients with biopsies before primary surgeries were included
  2. &: These different mistakes might overlap in the primary treatment of the same patients