Resection margins in oral cancer surgery: Room for improvement

• Published in: Head & neck Vol. 38; no. S1; pp. E2197 - E2203
• Main Authors: Smits, Roeland W.H., Koljenović, Senada, Hardillo, Jose A., ten Hove, Ivo, Meeuwis, Cees A., Sewnaik, Aniel, Dronkers, Emilie A.C., Bakker Schut, Tom C., Langeveld, Ton P.M., Molenaar, Jan, Hegt, V. Noordhoek, Puppels, Gerwin J., Baatenburg de Jong, Robert J.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.04.2016
• Subjects: Frozen Sections; head and neck cancer; Humans; Margins of Excision; mouth neoplasms; Mouth Neoplasms - pathology; Mouth Neoplasms - surgery; Neoplasm Recurrence, Local - prevention & control; oral cancer; oral surgery; Retrospective Studies; squamous cell carcinoma; oral surgery; head and neck cancer; mouth neoplasms; oral cancer; squamous cell carcinoma
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.24075

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