Resection margins in oral cancer surgery: Room for improvement |
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| Authors: | Roeland WH Smits MD Senada Koljenović MD PhD Jose A Hardillo MD PhD Ivo ten Hove MD Cees A Meeuwis MD PhD Aniel Sewnaik MD PhD Emilie AC Dronkers MD Tom C Bakker Schut MSc PhD Ton PM Langeveld MD PhD Jan Molenaar BSc V Noordhoek Hegt MD PhD Gerwin J Puppels MSc PhD Robert J Baatenburg de Jong MD PhD |
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| Affiliation: | 1. Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Medical Center Rotterdam, Rotterdam, The Netherlands;2. Center for Optical Diagnostics and Therapy, Department of Dermatology, Erasmus University Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands;3. Department of Pathology, Erasmus University Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands;4. Department of Oral and Maxillofacial surgery, Erasmus University Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands;5. Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University, Medical Center, Leiden, The Netherlands;6. Department of Oncology Documentation, Leiden University Medical Center, Leiden, The Netherlands |
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| Abstract: | The purpose of this review was to identify publications on resection margins in oral cancer surgery and compare these with the results from 2 Dutch academic medical centers. Eight publications were considered relevant for this study, reporting 30% to 65% inadequate resection margins (ie, positive and close margins), compared to 85% in Dutch centers. However, clinical outcome in terms of overall survival and recurrence seemed comparable. The misleading difference is caused by lack of unanimous margin definition and differences in surgicopathological approaches. This prevents comparison between the centers. Data from Dutch centers showed that inadequate resection margins have a significantly negative effect on local recurrence, regional recurrence, distant metastasis, and overall survival. These results confirm the need for improvement in oral cancer surgery. We underline the need for consistent protocols and optimization of frozen section procedures. We comment on development of optical techniques for intraoperative assessment of resection margins. © 2015 Wiley Periodicals, Inc. Head Neck 38 : E2197–E2203, 2016 |
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| Keywords: | squamous cell carcinoma oral surgery mouth neoplasms oral cancer head and neck cancer |
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