Estimation of the width of free margin with a significant impact on local recurrence in surgical resection of oral squamous cell carcinoma

Yamada, Shin‐ichi; Kitamura, Hiroshi; Shimane, Tetsu; Kamata, Toshihide; Uehara, Shinobu; Tanaka, Hirokazu; Yamamoto, Takeo

doi:10.1016/j.ijom.2015.09.024

Cited by 34 publications

(23 citation statements)

References 22 publications

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“…50 OSCC cases with free margins of ≤4 mm were related to an increased risk of local recurrence, while cases with free margins of ≥5 mm were not related to a significant risk of local recurrence. 51 According to El-Fol et al, a significant discrepancy was observed between intraoperative and histopathological margin assessment due to tissue shrinkage, and in addition such discrepancies were associated with the anatomic location of the tumour. For example, the buccal mucosa presented with a statistically significant mean discrepancy of 47.6% between the in situ and the histopathological margins of all close and positive margins.…”

Section: Histopathological Factorsmentioning

confidence: 99%

Clinico-pathological prognosticators in oral squamous cell carcinoma

Majumdar¹,

Patil

Sarode

et al. 2017

Translational Research in Oral Oncology

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Despite diagnostic and therapeutic advancements, mortality and morbidity rates in the patients diagnosed with oral cancer remain static. Hence, an understanding of the factors that predict the progression of oral cancer appears to be useful in deciding on the most appropriate therapy, thereby improving survival. To do so in practice, a critical knowledge of prognostic markers that have high sensitivity is essential. Though recent research has introduced newer molecular markers, challenging the conventional prognostic assessment methods their universal application is yet to be determined. In practice, clinical and histopathological parameters are widely used for the selection of treatment strategies and for the determination of prognosis in oral cancer patients. A literature search yielded a multitude of parameters to be involved in the determination of prognosis of a patient. Based on published evidence, factors of significance were pTNM, tumour volume, depth of invasion, surgical margin status, tumour budding, vascular and perineural invasion, medullary bone invasion, extracapsular spread and the presence of distant metastasis.

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Section: Histopathological Factorsmentioning

confidence: 99%

Clinico-pathological prognosticators in oral squamous cell carcinoma

Majumdar¹,

Patil

Sarode

et al. 2017

Translational Research in Oral Oncology

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“…Panel B shows that whereas multiple tumor bed margins show negative results, these are only narrowly clear of the tumor front, which is not included as a reference point for the pathologist. Several studies have ascribed poor outcomes with close final margins (less than 5 mm of radial clearance), with a three‐fold increased risk of recurrence and a corresponding negative impact on survival outcomes . Panel B demonstrates that even when a positive result returns (as seen in the anterior margin), these unoriented margins provide poor localizing information for the pathologist to communicate back to the surgeon during revision efforts.…”

Section: Introductionmentioning

confidence: 99%

Surgical margins in oral cavity squamous cell carcinoma: Current practices and future directions

et al. 2019

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Objective: To discuss the current available techniques for intraoperative margin assessment in the surgical treatment of oral squamous cell carcinoma (OSCC) through a review of the available literature.Methods: A systematic review was undertaken of the available English literature between 2008 through 2018 regarding surgical margins in OCSS. A total of 893 relevant articles were returned; 144 met criteria for review; and 64 articles were included.Results: In this review, we discuss the data surrounding the use of frozen section in OCSS. Additionally, alternative techniques for margin assessment are discussed, including Mohs, molecular analysis, nonfluorescent dyes, fluorescent dyes, autofluorescent imaging, narrow-band imaging, optical coherence tomography, confocal microscopy, high-resolution microendoscopy, and spectroscopy. For each technique, particular emphasis is placed on the local recurrence, disease-free survival, and overall survival rates when available.Conclusion: This review provides support for the practice of specimen-driven margin assessment when using frozen section analysis to improve the utility of the results. Finally, several alternatives for intraoperative margin assessment currently under investigation, including pathologic, wide-field imaging and narrow-field imaging techniques, are presented. We aim to fuel further investigation into methods for margin assessment that will improve survival for patients with OSCC through a critical analysis of the available techniques.

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“…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. According to most authors, an adequate pathological margin is at least 5 mm.…”

Section: Margins According To Proximitymentioning

confidence: 99%

“…However, because microscopic tumor extension from the tumor margin in a T1 mass does not exceed 3 mm 2 , they suggest that the surgical safety margin be redefined according to tumor size2. Yamada et al9 found that the risk of local recurrence did not differ significantly between surgical margins of 5 mm vs those more than 5 mm, whereas a significant difference between a clear margin and a close or tumor-involved margin was evident. They suggest that a surgical margin of about 5 mm is sufficient and thus that a surgical margin of more than 5 mm is not necessary for local control9.…”

Section: Locoregional Control With Surgical Marginmentioning

confidence: 99%

Surgical margins for the extirpation of oral cancer

Park

2016

J Korean Assoc Oral Maxillofac Surg

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Estimation of the width of free margin with a significant impact on local recurrence in surgical resection of oral squamous cell carcinoma

Cited by 34 publications

References 22 publications

Clinico-pathological prognosticators in oral squamous cell carcinoma

Clinico-pathological prognosticators in oral squamous cell carcinoma

Surgical margins in oral cavity squamous cell carcinoma: Current practices and future directions

Surgical margins for the extirpation of oral cancer

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