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Does a specimen‐based margin analysis of early tongue cancer better predict local control?
Author(s) -
Varvares Mark A.,
Walker Ronald J,
Chiosea Simion
Publication year - 2016
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26081
Subject(s) - medicine , tongue , head and neck cancer , surgery , cancer , glossectomy , retrospective cohort study , primary tumor , basal cell , radiation therapy , pathology , metastasis
BACKGROUND Oral cavity cancer continues to be a significant disease in the United States despite decreasing smoking rates. Surgery remains the primary treatment modality for operable oral cavity cancer, with adjuvant therapy reserved for patients with high-risk histologic characteristics. The ability to achieve primary-site disease control is directly related to the completeness of the surgical resection. Maintaining a disease-free primary site and preventing local recurrence is key to improving overall survival, particularly in patients with early cancer without nodal disease. A survey of head and neck surgeons indicated that the majority determines surgical margins by obtaining intraoperative frozen sections from the tumor bed. A survey of pathologists likewise indicated that most received small pieces of tissue from the surgeon for frozen section analysis. Three recent studies that address this issue in oral cancer resections, one retrospective, and two prospective, with all including cohorts of both specimen and tumor bed based analysis suggest that margin sampling from the main resection specimen, a specimen-driven approach, may more accurately determine the adequacy of resection and better predict local control.