Abstract
Purpose of reviewTo summarize recent findings regarding surgical management of oral squamous cell cancer (OSCC) through analysis of different intraoperative techniques for assessment of margins, evaluate the pros and cons of each, and ensuing prognostic impact.Recent findings'En bloc' OSCC resection and histopathologic evaluation of margins on the formalin-fixed specimen remain the 'gold standard' for oral oncologic surgery, whereas assessment of intraoperative surgical margins and its overall clinical value are still questioned and debated in the literature. The commonly applied evaluation of frozen sections still raises concerns regarding its efficacy and reproducibility; therefore, several ancillary diagnostic methods have entered the field of head and neck oncology in the last decades, aiming to support the surgeon in achieving tumor-free margins during ablative procedures.SummaryPoor prognosis of OSCC is strongly associated with residual tumor after surgery. Negative surgical margins are one of the strongest prognosticators for disease-free survival and locoregional control, but their intraoperative determination seems still to be suboptimal and needs better refinement. The most studied techniques to assess intraoperative margins include fluorescence, Raman spectroscopy, narrow band imaging, optical coherence tomography, and cytological bone margins analysis; each has its unique characteristics that are described in detail herein.
| Original language | English |
|---|---|
| Pages (from-to) | 98-103 |
| Number of pages | 6 |
| Journal | Current Opinion in Otolaryngology and Head and Neck Surgery |
| Volume | 27 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Apr 1 2019 |
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Keywords
- intraoperative assessment
- margin
- oncologic outcomes
- oral cancer
- surgery
ASJC Scopus subject areas
- Surgery
- Otorhinolaryngology
Cite this
Surgical margins in oral squamous cell cancer : Intraoperative evaluation and prognostic impact. / Mannelli, Giuditta; Comini, Lara Valentina; Piazza, Cesare.
In: Current Opinion in Otolaryngology and Head and Neck Surgery, Vol. 27, No. 2, 01.04.2019, p. 98-103.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Surgical margins in oral squamous cell cancer
T2 - Intraoperative evaluation and prognostic impact
AU - Mannelli, Giuditta
AU - Comini, Lara Valentina
AU - Piazza, Cesare
PY - 2019/4/1
Y1 - 2019/4/1
N2 - Purpose of reviewTo summarize recent findings regarding surgical management of oral squamous cell cancer (OSCC) through analysis of different intraoperative techniques for assessment of margins, evaluate the pros and cons of each, and ensuing prognostic impact.Recent findings'En bloc' OSCC resection and histopathologic evaluation of margins on the formalin-fixed specimen remain the 'gold standard' for oral oncologic surgery, whereas assessment of intraoperative surgical margins and its overall clinical value are still questioned and debated in the literature. The commonly applied evaluation of frozen sections still raises concerns regarding its efficacy and reproducibility; therefore, several ancillary diagnostic methods have entered the field of head and neck oncology in the last decades, aiming to support the surgeon in achieving tumor-free margins during ablative procedures.SummaryPoor prognosis of OSCC is strongly associated with residual tumor after surgery. Negative surgical margins are one of the strongest prognosticators for disease-free survival and locoregional control, but their intraoperative determination seems still to be suboptimal and needs better refinement. The most studied techniques to assess intraoperative margins include fluorescence, Raman spectroscopy, narrow band imaging, optical coherence tomography, and cytological bone margins analysis; each has its unique characteristics that are described in detail herein.
AB - Purpose of reviewTo summarize recent findings regarding surgical management of oral squamous cell cancer (OSCC) through analysis of different intraoperative techniques for assessment of margins, evaluate the pros and cons of each, and ensuing prognostic impact.Recent findings'En bloc' OSCC resection and histopathologic evaluation of margins on the formalin-fixed specimen remain the 'gold standard' for oral oncologic surgery, whereas assessment of intraoperative surgical margins and its overall clinical value are still questioned and debated in the literature. The commonly applied evaluation of frozen sections still raises concerns regarding its efficacy and reproducibility; therefore, several ancillary diagnostic methods have entered the field of head and neck oncology in the last decades, aiming to support the surgeon in achieving tumor-free margins during ablative procedures.SummaryPoor prognosis of OSCC is strongly associated with residual tumor after surgery. Negative surgical margins are one of the strongest prognosticators for disease-free survival and locoregional control, but their intraoperative determination seems still to be suboptimal and needs better refinement. The most studied techniques to assess intraoperative margins include fluorescence, Raman spectroscopy, narrow band imaging, optical coherence tomography, and cytological bone margins analysis; each has its unique characteristics that are described in detail herein.
KW - intraoperative assessment
KW - margin
KW - oncologic outcomes
KW - oral cancer
KW - surgery
UR - http://www.scopus.com/inward/record.url?scp=85062640297&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85062640297&partnerID=8YFLogxK
U2 - 10.1097/MOO.0000000000000516
DO - 10.1097/MOO.0000000000000516
M3 - Review article
C2 - 30844923
AN - SCOPUS:85062640297
VL - 27
SP - 98
EP - 103
JO - Current Opinion in Otolaryngology and Head and Neck Surgery
JF - Current Opinion in Otolaryngology and Head and Neck Surgery
SN - 1068-9508
IS - 2
ER -