Surgical margins in head and neck cancer: Intra- and postoperative considerations

Auris, Nasus, Larynx
K Thomas RobbinsAlfio Ferlito

Abstract

To provide a perspective on the significance of recent reports for optimizing cancer free surgical margins that have challenged standard practices. We conducted a review of the recent literature (2012-2018) using the keywords surgical margin analysis, frozen and paraffin section techniques, head and neck cancer, spectroscopy and molecular markers. Of significance are the reports indicating superiority of tumor specimen directed sampling of margins compared to patient directed (tumor bed) sampling for frozen section control of oral cancers. With reference to optimal distance between tumor and the surgical margin, recent reports recommended cutoffs less than 5mm. Employment of new technologies such as light spectroscopy and molecular analysis of tissues, provide opportunities for a "real time" assessment of surgical margins. The commonly practiced method of patient directed margin sampling involving previous studies raises concern over conclusions made regarding the efficacy of frozen section margin control. The recent studies that challenge the optimal distance for clear surgical margins are retrospective and address patient cohorts with inherently confounding factors. The use of novel ancillary techniques require further refine...Continue Reading

Citations

Mar 8, 2019·Current Opinion in Otolaryngology & Head and Neck Surgery·Giuditta MannelliCesare Piazza
Apr 2, 2019·Oral Diseases·Giancarlo TirelliFrancesca Boscolo Nata
Oct 17, 2019·The Analyst·Thomas James Eliot HubbardNicholas Stone
Feb 20, 2020·Lasers in Surgery and Medicine·Frederic De LeeuwCorinne Laplace-Builhé
May 6, 2020·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Giancarlo TirelliMargherita Tofanelli
Nov 6, 2020·Annals of Surgical Oncology·Thamizhp Pozhil GunaS Bharathi
May 31, 2019·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Stan van KeulenEben Rosenthal
Feb 18, 2021·Oral Oncology·Yash P MerchantVishal U S Rao

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