Microscopic cut-through of cancer in the surgical treatment of squamous carcinoma of the tongue

Scholl, Peter F.; Byers, Robert M.; Batsakis, John G.; Wolf, Pat; Santini, Hector

doi:10.1016/0002-9610(86)90304-1

Cited by 145 publications

(109 citation statements)

References 9 publications

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“…This significant difference is reflected in survival where the survival at 5 years in the group of patients with a positive resection margin was 12% less than for those with clear margins. The detrimental effect of positive resection margins has been noted in several previous studies (Lee, 1974;Byers et al, 1978;Looser et al, 1978;Chen et al, 1987;Scholl et al, 1986).…”

Section: Discussionmentioning

confidence: 80%

“…This finding is surprising but has been noted before (Byers et al, 1978;Scholl et al, 1986;Cook et al, 1993 The most satisfactory treatment is, of course, to completely excise the tumour at the first operation and peroperative frozen section histological examination is helpful in achieving this end.…”

Section: Discussionmentioning

confidence: 96%

“…Approximately 25% of patients with negative margins will still go on to develop a recurrence at the primary site (Lee, 1974;Byers et al, 1978;Looser et al, 1978;Chen et al, 1987;Scholl et al, 1986).…”

mentioning

confidence: 99%

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Do positive resection margins after ablative surgery for head and neck cancer adversely affect prognosis? A study of 352 patients with recurrent carcinoma following radiotherapy treated by salvage surgery

Jones

Hanafi²,

Nadapalan³

et al. 1996

Br J Cancer

121

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SummaryIt is generally accepted by surgeons that failure to eradicate malignant disease at the primary site has an adverse effect on survival. The present study investigates 352 patients with squamous carcinoma of the head and neck treated by primary radical radiotherapy and who subsequently underwent surgical ablation for a recurrent carcinoma. A total of 303 (86%) patients had a negative resection margin and 49 (14%) had a positive resection margin. Oral carcinoma was 1.7 times more likely to be associated with a positive margin than other tumours (P=0.0292). Actuarial calculations demonstrated that 47% of patients with negative margins and 66% of patients with positive margins developed a primary site recurrence (P=0.0286). Neck node recurrence occurred in 10% of those patients with negative margins and 12% of patients with positive margins. Patients with positive margins had a significantly poorer survival than those with negative margins (P = 0.022). Multivariate analysis failed to confirm any independent adverse effect from a positive margin. The 5 year tumour-specific survival of patients with a positive margin was poorer by 12% than for those patients with a negative margin. The pattern of failure differed between the two groups, with patients having positive margins tending to die of local recurrence.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 96%

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Do positive resection margins after ablative surgery for head and neck cancer adversely affect prognosis? A study of 352 patients with recurrent carcinoma following radiotherapy treated by salvage surgery

Jones

Hanafi²,

Nadapalan³

et al. 1996

Br J Cancer

121

View full text Add to dashboard Cite

show abstract

“…However, this concept has recently been challenged by several studies in which pathologically document that adequate margins cannot necessarily guarantee tumor cells are removed completely [62][63][64][65][66] and patients with clear margins do not always have good clinical outcomes, as local recurrence rates with clear margins in tongue cancer ranged from 4% to 18% [56,58,62]. As a result, there is not a single definition for an adequate resection margin.…”

Section: Surgical Margin Statusmentioning

confidence: 99%

A review of clinical and histological parameters associated with contralateral neck metastases in oral squamous cell carcinoma

et al. 2011

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Oral squamous cell carcinoma (OSCC) has a high incidence of cervical micrometastases and sometimes metastasizes contralaterally because of the rich lymphatic intercommunications relative to submucosal plexus of oral cavity that freely communicate across the midline, and it can facilitate the spread of neoplastic cells to any area of the neck consequently. Clinical and histopathologic factors continue to provide predictive information to contralateral neck metastases (CLNM) in OSCC, which determine prophylactic and adjuvant treatments for an individual patient. This review describes the predictive value of clinical-histopathologic factors, which relate to primary tumor and cervical lymph nodes, and surgical dissection and adjuvant treatments. In addition, the indications for elective contralateral neck dissection and adjuvant radiotherapy (aRT) and strategies for follow-up are offered, which is strongly focused by clinicians to prevent later CLNM and poor prognosis subsequently.

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“…A prerequisite is to remove the whole tumor with a sufficient safety margin 1,2 . Reconstruction surgical procedures in oncosurgery include local flap, reconstruction of soft tissue defects using free dermo-epidermal grafts and complex microsurgical procedures.…”

Section: Introductionmentioning

confidence: 99%

Reconstructive procedures in maxillofacial oncosurgery

Pink¹,

Molitor²,

Tvrdý³

et al. 2016

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Objective. Oropharyngeal cancers are a biologically heterogenous group of tumors with diverse risk factors including tobacco, alcohol, HPV, inherited disorders, the acquired immunodeficiency of Karposi's Sarcoma and non Hodgkin's lymphoma. In the Czech Republic, oropharyngeal cancers represent around 2% of all cancers. The treatment of these tumors is long and complex. Reconstructive procedures in maxillofacial oncosurgery demand good interdisciplinary collaboration and great professional preparedness of the surgical and nursing team. Patient age and stage of disease, including the presence of metastases are of key importance. A prerequisite for the success of surgical treatment is removal of the tumor with a sufficient safety margin. Reconstructive procedures then follow. Aim. To highlight the importance of radical tumor resection and describe reconstruction of the defect in a group of our patients. Methods and Results. From 2008 to 2013, 23 patients with oropharyngeal carcinoma underwent radical surgical removal of tumor, followed by reconstruction of postoperative defects using distant and free flaps. The histopathology showed predominantly squamous cell carcinomas and one of Merkel cell carcinoma. 16 patients had malignant disease detected in III-IV. In only 7 cases was treatment initiated in the first and second stages of the disease. In these patients, the tumors were removed with a safety margin of healthy tissue and in none, did the basic cancer recur . The postoperative course in terms of flap engraftment and overall condition of the patient was uneventful. All of these patients still enjoy a good life quality with a current mean survival in range 5 -76 months. Radical surgical removal of a malignant tumor in the early stages of the disease is associated with fewer postoperative complications and longer survival. Conclusion. To avoid the risk of local and/or systemic postoperative complications, appropriate patient selection is important. Overall, the traditional, classic reconstructive procedures with the use of prostheses, in many cases is still the best option in our experience.

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Microscopic cut-through of cancer in the surgical treatment of squamous carcinoma of the tongue

Cited by 145 publications

References 9 publications

Do positive resection margins after ablative surgery for head and neck cancer adversely affect prognosis? A study of 352 patients with recurrent carcinoma following radiotherapy treated by salvage surgery

Do positive resection margins after ablative surgery for head and neck cancer adversely affect prognosis? A study of 352 patients with recurrent carcinoma following radiotherapy treated by salvage surgery

A review of clinical and histological parameters associated with contralateral neck metastases in oral squamous cell carcinoma

Reconstructive procedures in maxillofacial oncosurgery

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