Influence of close resection margins on local recurrence and disease-specific survival in oral and oropharyngeal carcinoma

Wong, Ling S.; McMahon, Jeremy; Devine, J.C.; McLellan, Douglas; Thompson, Ewen; Farrow, Adrian; Moos, K.F.; Ayoub, Ashraf

doi:10.1016/j.bjoms.2011.05.008

Cited by 88 publications

(82 citation statements)

References 18 publications

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“…Whilst those studies that use the definition of an involved margin as tumour at the resection have an average of approximately 5-10%, those that state <1mm as involved exhibit skewed data with figures as high as 24% [6]. Perhaps for this reason, recent research has focused on the definition of the close surgical margin, as this is seen as the 'grey' area of deciding whether adjuvant treatment is required [5,8].…”

Section: Discussionmentioning

confidence: 99%

“…Whilst several factors account for poor outcomes within the treatment of OSCC, surgical margin clearances a recognised negative prognostic indicator of local recurrence with mixed evidence of its impact upon long-term survival [2][3][4][5][6][7][8]. Current UK guidelines set the goal of 10mm as the gold standard for macroscopic margin clearance [9].…”

Section: Introductionmentioning

confidence: 99%

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Factors Influencing the Status of the Surgical Margin in the Resection of Oral Squamous Cell Carcinoma

Payne¹

2017

BJSTR

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factors Influencing the Status of the Surgical Margin in the Resection of Oral Squamous Cell Carcinoma

Payne¹

2017

BJSTR

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“…But recent publication by Barrya et al [20] in which author compared recurrences between pT1, T2 N0 and pT1, pT2 regardless of neck status or radiotherapy did not find any statistical difference between patients with margin of 3.0–4.9 and >5.0. Wong et al [30] suggested that surgical margins within 2 mm should be considered the cut-off for recommendation of PORT. Ch'ng et al [31] also have concluded that patients with close margins had acceptable local control without PORT in the absence of other risk factors.…”

Section: Discussionmentioning

confidence: 99%

Close Margins in Oral Cancers: Implication of Close Margin Status in Recurrence and Survival of pT1N0 and pT2N0 Oral Cancers

Gokavarapu

Chander

Parvataneni³

et al. 2014

International Journal of Surgical Oncology

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Introduction. Among all prognostic factors, “margin status” is the only factor under clinician's control. Current guidelines describe histopathologic margin of >5 mm as “clear margin” and 1–5 mm as “close margin.” Ambiguous description of positive margin in the published data resulted in comparison of microscopically “involved margin” and “close margin” together with “clear margin” in many publications. Authors attempted to compare the outcome of close and clear margins of stage I and stage II squamous cell carcinoma of oral cavity to investigate the efficacy of description of margin status. Patients and Methods. Historical cohorts of patients treated between January 2010 and December 2011 at tertiary cancer hospital were investigated and filtered for stage I and stage II primary squamous cell carcinomas of oral cavity. Patients with margin status of tumor at margin or within 1mm from cut margin were excluded and analyzed in multivariate logistic regression model for locoregional recurrences and Cox regression for overall survival. Results. A total of 104 patients fulfilled the abovementioned criteria, of whom 36 were “clear margin” and 68 were “close margin” with median period of follow-up of 39 months. There was no significant difference in locoregional recurrence (P value: 0.0.810) and survival (P value: 0.0.851) among “close margin” and “clear margin” patients.

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“…When considering the clinical impact of these results, there is a significant adverse association between tissue margins less than 1.6mm and disease specific survival in SCC [39]. Assuming the recommended 4mm margin is followed, the maximum cutting deviation permissible to clear a tumor margin is 2.4mm.…”

Section: Methodsmentioning

confidence: 99%

Semi-autonomous electrosurgery for tumor resection using a multi-degree of freedom electrosurgical tool and visual servoing

Opfermann

Léonard

Decker

et al. 2017

2017 IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS)

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This paper specifies a surgical robot performing semi-autonomous electrosurgery for tumor resection and evaluates its accuracy using a visual servoing paradigm. We describe the design and integration of a novel, multi-degree of freedom electrosurgical tool for the smart tissue autonomous robot (STAR). Standardized line tests are executed to determine ideal cut parameters in three different types of porcine tissue. STAR is then programmed with the ideal cut setting for porcine tissue and compared against expert surgeons using open and laparoscopic techniques in a line cutting task. We conclude with a proof of concept demonstration using STAR to semi-autonomously resect pseudo-tumors in porcine tissue using visual servoing. When tasked to excise tumors with a consistent 4mm margin, STAR can semi-autonomously dissect tissue with an average margin of 3.67 mm and a standard deviation of 0.89mm.

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Influence of close resection margins on local recurrence and disease-specific survival in oral and oropharyngeal carcinoma

Cited by 88 publications

References 18 publications

Factors Influencing the Status of the Surgical Margin in the Resection of Oral Squamous Cell Carcinoma

Factors Influencing the Status of the Surgical Margin in the Resection of Oral Squamous Cell Carcinoma

Close Margins in Oral Cancers: Implication of Close Margin Status in Recurrence and Survival of pT1N0 and pT2N0 Oral Cancers

Semi-autonomous electrosurgery for tumor resection using a multi-degree of freedom electrosurgical tool and visual servoing

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