IntroductionAchieving adequate resection margins during oral cancer surgery is important to improve patient prognosis. Surgeons have the delicate task of achieving an adequate resection and safeguarding satisfactory remaining function and acceptable physical appearance, while relying on visual inspection, palpation, and preoperative imaging. Intraoperative assessment of resection margins (IOARM) is a multidisciplinary effort, which can guide towards adequate resections. Different forms of IOARM are currently used, but it is unknown how accurate these methods are in predicting margin status. Therefore, this review aims to investigate: 1) the IOARM methods currently used during oral cancer surgery, 2) their performance, and 3) their clinical relevance.MethodsA literature search was performed in the following databases: Embase, Medline, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, and Google Scholar (from inception to January 23, 2020). IOARM performance was assessed in terms of accuracy, sensitivity, and specificity in predicting margin status, and the reduction of inadequate margins. Clinical relevance (i.e., overall survival, local recurrence, regional recurrence, local recurrence-free survival, disease-specific survival, adjuvant therapy) was recorded if available.ResultsEighteen studies were included in the review, of which 10 for soft tissue and 8 for bone. For soft tissue, defect-driven IOARM-studies showed the average accuracy, sensitivity, and specificity of 90.9%, 47.6%, and 84.4%, and specimen-driven IOARM-studies showed, 91.5%, 68.4%, and 96.7%, respectively. For bone, specimen-driven IOARM-studies performed better than defect-driven, with an average accuracy, sensitivity, and specificity of 96.6%, 81.8%, and 98%, respectively. For both, soft tissue and bone, IOARM positively impacts patient outcome.ConclusionIOARM improves margin-status, especially the specimen-driven IOARM has higher performance compared to defect-driven IOARM. However, this conclusion is limited by the low number of studies reporting performance results for defect-driven IOARM. The current methods suffer from inherent disadvantages, namely their subjective character and the fact that only a small part of the resection surface can be assessed in a short time span, causing sampling errors. Therefore, a solution should be sought in the field of objective techniques that can rapidly assess the whole resection surface.

Objective: Psoriatic arthritis (PsA) is a member of the spondyloarthropathy (SpA) group of diseases, it can lead to joint damage by causing bone erosions and/or new bone formation in the axial or peripheral musculoskeletal system.Symphysis pubis is an important joint area that can be frequently involved in rheumatological diseases. Pubic radiological changes have been evaluated in some rheumatological disease except PsA. In our study, we aimed to investigate the symphysis pubis joint changes in PsA. Materials and Methods: Pelvic and sacroiliac joint radiographs of 61 PsA patients were retrospectively analyzed. All patients were older than 18 years of age, met the criteria for the Classification Criteria for Psoriatic Artritis (CASPAR), had no history of pubic trauma, had a disease duration of at least 5 years. Articular involvement patterns of the patients (asymmetric oligoarticular, symmetrical polyarticular, distal interphalangeal joint and axial involvement), dactylitis, scalp and nail involvement were also examined, and the relationship of these clinical conditions with changes in the symphysis pubis was investigated. Results:In the study, the data of 61 patients, 41 (67.2%) female and 20 (32.8%) male, diagnosed with PsA according to the CASPAR criteria were evaluated. There was pubic involvement in 15 (26.2%) patients. Sacroiliac involvement, scalp involvement of psoriasis and presence of dactylitis were found to be higher in patients with pubic involvement.Axially involved PsA (60%) was the most common in those with pubic involvement. Conclusion: We showed that there are pubic changes in patients and that pubic involvement is more common in the presence of scalp involvement and dactylitis.

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