Positive frozen section margins predict local recurrence in R0-resected squamous cell carcinoma of the head and neck

Ettl, Tobias; El-Gindi, Alain; Hautmann, Matthias G.; Gosau, Martin; Weber, Florian; Rohrmeier, Christian; Gerken, Michael; Müller, Steffen; Reichert, Torsten E.; Klingelhöffer, Christoph

doi:10.1016/j.oraloncology.2016.02.012

Cited by 69 publications

(77 citation statements)

References 29 publications

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“…Some authors, however, indicated that the p16 detection in oral cancer does not seem to reliably correlate with HPV status . Despite the advances in modern diagnostics and therapeutic options, the survival rates remain around 50%, mainly due to the frequent development of local recurrence . The current treatment of choice comprises surgical resection alone for early, superficial lesions, whereas advanced cases usually require adjuvant treatment following surgery .…”

Section: Introductionmentioning

confidence: 99%

Positive fresh frozen section margins as an adverse independent prognostic factor for local recurrence in oral cancer patients

et al. 2017

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Section: Introductionmentioning

confidence: 99%

Positive fresh frozen section margins as an adverse independent prognostic factor for local recurrence in oral cancer patients

et al. 2017

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“…It has been previously shown that reliance on tumor bed margins alone (Group 3 in this study) correlates with worse local control and should no longer be considered a viable method of margin assessment [6,7,9,11–13,15,16]. Prognostically relevant margin information is best derived from the resection specimen.…”

Section: Discussionmentioning

confidence: 92%

Improving margin revision: Characterization of tumor bed margins in early oral tongue cancer

et al. 2017

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Objectives To improve margin revision, this study characterizes the number, fragmentation, and orientation of tumor bed margins (TBM) in patients with pT1-2 pN0 squamous cell carcinoma (SCC) of the oral tongue. Materials and Methods Pathology reports (n = 346) were reviewed. TBM parameters were indexed. In Group 1 patients all margins were obtained from the glossectomy specimen and there were no TBM. In Revision Group/Group 2 (n = 103), tumor bed was sampled to revise suboptimal margins identified by examination of the glossectomy specimen. In Group 3 (n = 124), TBM were obtained before examination of the glossectomy specimen. Results and Conclusions Fewer TBMs were obtained per patient in Group 2 compared to Group 3 (57/103, 55% of patients with < 3 vs. 117/124, 94%, ≥3 TBMs, respectively). The new margin surface was more frequently indicated in Group 2 compared to Group 3 (59/103, 57%, vs. 19/124, 15%, p < .001). If glossectomy specimen margins are accepted as the reference standard, then the TBM was 15% sensitive in Group 2 (95% confidence interval [CI], 7–29) and 32% sensitive in Group 3 (95% CI, 15–55). TBM fragmentation (23/103, 22% vs. 42/124, 34%) and frozen vs. permanent discrepancies (8/103, 3% vs. 3/124, 2%) were similar between Groups 2 and 3. The new margin surface was not indicated in 6 of 11 cases with discrepant frozen vs. permanent pathology findings, precluding judgment on final margin status. To facilitate the assessment of final margins, TBM should be represented by one tissue fragment with a marked new margin surface.

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“…However, there is no clear distinction among the three. Depending on the definition, positive margins may include the carcinoma in situ but not dysplasia1, involve the microscopic tumor6, or be less than 1 mm7. Close margins have been defined as 3 mm or less6, 4 mm or less8, and 1 mm to 4.9 mm7.…”

Section: Margins According To Proximitymentioning

confidence: 99%

“…Depending on the definition, positive margins may include the carcinoma in situ but not dysplasia1, involve the microscopic tumor6, or be less than 1 mm7. Close margins have been defined as 3 mm or less6, 4 mm or less8, and 1 mm to 4.9 mm7. An adequate clear margin is thought to be more than 3 mm6, more than 5 mm179, or 7 mm4.…”

Section: Margins According To Proximitymentioning

confidence: 99%

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Surgical margins for the extirpation of oral cancer

Park

2016

J Korean Assoc Oral Maxillofac Surg

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Positive frozen section margins predict local recurrence in R0-resected squamous cell carcinoma of the head and neck

Cited by 69 publications

References 29 publications

Positive fresh frozen section margins as an adverse independent prognostic factor for local recurrence in oral cancer patients

Positive fresh frozen section margins as an adverse independent prognostic factor for local recurrence in oral cancer patients

Improving margin revision: Characterization of tumor bed margins in early oral tongue cancer

Surgical margins for the extirpation of oral cancer

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