The significance of clinical margins in CO₂ laser resected laryngeal squamous cell carcinoma and its impact on disease management: Our experience in twenty‐nine patients

Laryngeal exposure and margin status in glottic cancer treated by transoral laser microsurgery

“…This is possible thanks to the high magnification available with the operative microscope and the peculiar pattern of spreading of laryngeal tumors . However, the impact of positive margins after TLM remains a matter of debate . Firstly, the limit between positive and suspicious margins is difficult to establish because of thermal damage at the edge of the specimen, postresection and postfixation shrinkage, laser artifacts at the level of the cutting edges, and manipulation of the small piece of excised tissue .…”

“…9 However, the impact of positive margins after TLM remains a matter of debate. [10][11][12][13] Firstly, the limit between positive and suspicious margins is difficult to establish because of thermal damage at the edge of the specimen, postresection and postfixation shrinkage, laser artifacts at the level of the cutting edges, and manipulation of the small piece of excised tissue. 14,15 Moreover, the large number of margins deemed to be positive at histopathology is not always clinically reflected in a corresponding number of recurrences or persistences.…”

Intraoperative Narrow Band Imaging Better Delineates Superficial Resection Margins During Transoral Laser Microsurgery for Early Glottic Cancer

“…For these reasons, accurate histopathological assessment of the specimen should be carried out in close cooperation between the surgeon and a dedicated pathologist. 24,25 In this regard, HDTV-NBI may help in achieving a higher diagnostic accuracy by avoiding adjunctive tissue manipulation and staining. 23 Retreatment policies in cases of positive resection margins may vary from a second surgical procedure to postoperative RT, but both present distinctive disadvantages.…”

AHNS Series: Do you know your guidelines? Review of current knowledge on laryngeal cancer

“…These techniques were introduced in the 1970s and have been consistently evaluated regarding oncologic effectiveness and functional outcomes with excellent results into the modern era . This approach is often used in early‐stage disease and has the benefit of reduced morbidity compared to open surgical management or nonsurgical strategies . The tumor is resected using a laser (often carbon dioxide) coupled to an operating microscope.…”

“…[37][38][39][40] This approach is often used in early-stage disease and has the benefit of reduced morbidity compared to open surgical management or nonsurgical strategies. 37,41 The tumor is resected using a laser (often carbon dioxide) coupled to an operating microscope. This is used in the treatment of T1, T2, and select T3 tumors.…”