TY - JOUR
T1 - Surgical margins in oral cavity squamous cell carcinoma
T2 - Current practices and future directions
AU - Kain, Joshua J.
AU - Birkeland, Andrew C.
AU - Udayakumar, Neha
AU - Morlandt, Anthony B.
AU - Stevens, Todd M.
AU - Carroll, William R.
AU - Rosenthal, Eben L.
AU - Warram, Jason M.
N1 - Publisher Copyright:
© 2019 The American Laryngological, Rhinological and Otological Society, Inc.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - 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.
AB - 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.
KW - frozen section
KW - Oral cancer
KW - squamous cell carcinoma
KW - surgical margins
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U2 - 10.1002/lary.27943
DO - 10.1002/lary.27943
M3 - Review article
C2 - 31025711
AN - SCOPUS:85065121649
SN - 0023-852X
VL - 130
SP - 128
EP - 138
JO - Laryngoscope
JF - Laryngoscope
IS - 1
ER -