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Tumor clearance at resection margins in total laryngectomy. A clinicopathologic study
Author(s) -
Lam K. H.,
Lau W. F.,
Wei William I.
Publication year - 1988
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19880601)61:11<2260::aid-cncr2820611121>3.0.co;2-c
Subject(s) - laryngectomy , medicine , resection , clearance rate , surgery , larynx
The specimens from total laryngectomy performed in 70 patients were studied using the step‐serial whole organ sectioning technique. Transverse histologic sections were taken and examined for minimum tumor clearance. The clinical status of patients for at least 4 years of observation was correlated with microscopic clearance of margins. The actual presence of tumor at the margins of resection was found in 21 (30%) of the specimens. The tumor was found to reach within 1 mm, 2 mm, and more than 2 mm from the margins in nine (13%), four (6%), and 36 (51%) specimens, respectively. The anterolateral margin was most commonly involved (19%), followed by the posterolateral (11%), postcricoid (7%), and upper (1.4%) margins. Local recurrence was found to be related to degree of clearance as 10 of 21 (48%) patients with no clearance and one of nine (11%) with 1 mm clearance had local failure. None of the patients with 2 mm clearance or more developed local recurrence. It is concluded that step‐serial whole organ sectioning is an adequate method for thoroughly examining resection margins in laryngectomy specimens.