Quantification of surgical margin shrinkage in the oral cavity

Johnson, Robert E.; Sigman, June D.; Funk, Gerry F.; Robinson, Robert A.; Hoffman, Henry T.

doi:10.1002/(sici)1097-0347(199707)19:4<281::aid-hed6>3.0.co;2-x

Cited by 194 publications

(137 citation statements)

References 12 publications

(13 reference statements)

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“…However, the first reference regarding to the study of tissue shrinkage on surgical margins of resection in oral cavity and oropharynx is attributed to Johnson et al [9] in 1997. In their experimental study on ten mongrel dogs they reported that a shrink of up to 30-50% may be expected in the specimens of oral cavity and oropharynx and the maximum shrinkage occurs immediately after the resection.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8] However, although one goal in the oncologic surgery is the complete removal of the tumor with an appropriate margin of security and less aesthetic and functional impact; in the head and neck region, due to its three-dimensional characteristics and the presence of noble structures, the obtaining of appropriate limits of resection constitutes, on occasions, a real challenge for the surgeon. [9,10] Nevertheless, since 1978 when Looser et al [5] defined the term "positive surgical margin", diverse concepts such as "close margins", "involved margins" or "clear margins", among others, have been introduced in the literature without a general consensus. [10][11][12][13] In fact, even today, there are no universal guidelines that permit different pathologists to adopt the same histologic criteria regarding to surgical margin.…”

Section: Introductionmentioning

confidence: 99%

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The tissue shrinkage phenomenon on surgical margins in oral and oropharyngeal squamous cell carcinoma

González-Ballester¹

2016

PAR

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Aim: One of the most important factors associated with recurrence rate and overall survival is the status of surgical margin of resection free of disease. However, sometimes, the margins measured intra-operatively at the time of surgery differ of those measured by the pathologist in the histopathologic analysis. Faced with this dilemma, a literature review of the best available evidence was conducted in an attempt to determine how the phenomenon of tissue shrinkage may influence on the surgical margin of resection in patients undergoing oral and oropharyngeal squamous cell carcinoma (SCC). Methods: An electronic and manual search was conducted by one reviewer. A combination of controlled Medical Subjects Headings and keywords were used as search strategy. Inclusion and exclusion criteria were established. Results: Finally, after an exhaustive selection process, four articles fulfilled the inclusion criteria and were analyzed. All articles reported a decrease of surgical margin after resection. The tumor site and tumor stage seem to influence in degree of margin shrinkage. Conclusion: Tissue shrinkage on surgical margins of resection in oral SCC is a tangible phenomenon. There is a significant discrepancy between margins measured intraoperatively previous to resection and margins measured by pathologist after histologic processing. The highest percentage of retraction occurs at the time of resection. Margin shrinkage based on tumor site and tumor stage should be considered by any oncologic surgeon to ensure adequate margins of resection cleared of tumor.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The tissue shrinkage phenomenon on surgical margins in oral and oropharyngeal squamous cell carcinoma

González-Ballester¹

2016

PAR

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“…It has been reported that there may be a 20% to 47% shrinkage in tumor margins after a pathologic fixation procedure, especially for small tumors. 55,56 Therefore, it seems to not be practical to use the depth of tumor invasion or other pathologic parameters as a guideline to determine whether the patient should receive END or not. It will become 2 stages of surgery.…”

Section: Discussionmentioning

confidence: 99%

Neck treatment of patients with early stage oral tongue cancer

Huang

Kang

Lin

et al. 2008

Cancer

119

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Background: Intra myocardial hemorrhage lesions (IMH) are underdiagnosed complication of ST elevation myocardial infarction (STEMI). We sought to determine the incidence, predictors and the prognostic value of IMH in STEMI using cardiac MR imaging (CMR) techniques. Methods: We screened for inclusion consecutive patients with STEMI treated by percutaneous coronary intervention (PCI) within the first 12 hr of evolution. IMH lesions were identified on T2‐weighted sequences on CMR between days 4 and 8 after PCI. Adverse cardiac events were defined as a composite of death + severe ventricular arrhythmias + acute coronary syndrome + acute heart failure. Results: N = 114 patients were included and n = 11 patients (10%) presented IMH lesions. Patients with IMH lesions had a larger myocardial infarction extent (25.6 ± 1.8 vs. 13.5 ± 1.0 % LV mass, P < 0.01), microvascular obstructive lesions extent (4.6 ± 1.0 vs. 1.3 ± 0.3% LV mass, P < 0.01) and lower LV ejection fraction (40.7 ± 2.3% vs. 50.7 ± 1.3%, P < 0.01). The value of glycemia at admission was an independent predictor of IMH development (Odd ratio 1.8 [1.1–2.8] per mmol l−1, P = 0.01). The incidence of adverse cardiac events was higher in the IMH group than in the non‐IMH group during the first year following STEMI (P = 0.01, log‐rank analysis). Cox regression analysis identified the presence of IMH lesions as an independent predictor of adverse clinical outcome (Hazard Ratio = 2.8 [1.2–6.8], P = 0.02). Conclusion: Our study indicates that IMH is a rare but severe finding in STEMI, associated with a larger myocardial infarction and a worse clinical outcome. Per‐PCI glycemia might influence IMH development. © 2011 Wiley Periodicals, Inc.

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“…Few studies are reported in literature about the effect of thermal tissue injury in head and neck area, and the vast majority of them are based on animal or cadaveric models [11][12][13][14][15][16][17]; here, a laryngeal model, created using excised larynges, was developed to quantify the effect of thermal injury of different devices on laryngeal normal mucosa and to predict their effect on margins status and final histopathological report.…”

Section: Introductionmentioning

confidence: 99%

Impact of low-thermal-injury devices on margin status in laryngeal cancer. An experimental ex vivo study

et al. 2014

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We conducted a prospective study on 10 excised larynges from patients affected by advanced\ud laryngeal cancer, to assess the thermal-effect due to surgical incisions made at standard distance by\ud using: scalpel, CO2 Laser, harmonic scalpel and electrocautery. Upon histopathological examination, thermal\ud damage (Surgical Artifact, SA), tissue lost/retraction (Shrinkage, S), and tissue alterations were compared\ud for each instrument

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Quantification of surgical margin shrinkage in the oral cavity

Cited by 194 publications

References 12 publications

The tissue shrinkage phenomenon on surgical margins in oral and oropharyngeal squamous cell carcinoma

The tissue shrinkage phenomenon on surgical margins in oral and oropharyngeal squamous cell carcinoma

Neck treatment of patients with early stage oral tongue cancer

Impact of low-thermal-injury devices on margin status in laryngeal cancer. An experimental ex vivo study

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