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Surgical margins in oral cavity squamous cell carcinoma: Current practices and future directions
Author(s) -
Kain Joshua J.,
Birkeland Andrew C.,
Udayakumar Neha,
Morlandt Anthony B.,
Stevens Todd M.,
Carroll William R.,
Rosenthal Eben L.,
Warram Jason M.
Publication year - 2020
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.27943
Subject(s) - margin (machine learning) , medicine , frozen section procedure , optical coherence tomography , basal cell , surgical margin , oral cavity , radiology , medical physics , surgery , pathology , computer science , resection , dentistry , machine learning
Objective To discuss the current available techniques for intraoperative margin assessment in the surgical treatment of oral squamous cell carcinoma (OSCC) through a review of the available literature. Methods A systematic review was undertaken of the available English literature between 2008 through 2018 regarding surgical margins in OCSS. A total of 893 relevant articles were returned; 144 met criteria for review; and 64 articles were included. Results In this review, we discuss the data surrounding the use of frozen section in OCSS. Additionally, alternative techniques for margin assessment are discussed, including Mohs, molecular analysis, nonfluorescent dyes, fluorescent dyes, autofluorescent imaging, narrow‐band imaging, optical coherence tomography, confocal microscopy, high‐resolution microendoscopy, and spectroscopy. For each technique, particular emphasis is placed on the local recurrence, disease‐free survival, and overall survival rates when available. Conclusion This review provides support for the practice of specimen‐driven margin assessment when using frozen section analysis to improve the utility of the results. Finally, several alternatives for intraoperative margin assessment currently under investigation, including pathologic, wide‐field imaging and narrow‐field imaging techniques, are presented. We aim to fuel further investigation into methods for margin assessment that will improve survival for patients with OSCC through a critical analysis of the available techniques. Level of Evidence NA Laryngoscope , 130:128–138, 2020