Prognostic significance of the dysplastic margin for predicting recurrence and survival in patients with primary oral squamous cell carcinoma resected with curative intent: a systematic review protocol.

OBJECTIVE

The objective of this review is to evaluate whether the presence and severity of the dysplastic margin predicts recurrence or survival outcomes in patients with primary oral squamous cell carcinoma (OSCC) resected with curative intent.

INTRODUCTION

There is variable evidence whether a dysplastic OSCC margin predicts worse recurrence or survival outcomes and, therefore, no consensus on whether a dysplastic margin should be regarded as an involved margin. Ambiguity of the prognostic significance of dysplasia in the resection margin means that management is institutionally dependent.

ELIGIBILITY CRITERIA: This systematic review will include studies of patients with primary OSCC who have undergone surgery with curative intent, with or without adjuvant treatment. Studies will be included if they compare the recurrence and survival outcomes of dysplastic margins with clear, close, or involved margins.

METHODS

PubMed, Embase (Ovid), Web of Science Core Collection, Scopus, and gray literature will be searched. Two reviewers will independently undertake title/abstract and full-text screening. Included studies will be critically appraised using the QUIPS tool. Data extraction will use the CHARMS-PF checklist. Odds ratio, risk ratios, and hazard ratios along with standard errors, variances, or CIs will be extracted. Where possible, hazard ratios will be computed if not directly reported. Separate meta-analyses will be done for odds ratios, univariate hazard ratios, and multivariate hazard ratios. If meta-analysis is not possible, data will be synthesized narratively. The certainty of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, and a Summary of Findings will be presented.

REVIEW REGISTRATION: PROSPERO CRD42024604073.