Surgical margins in head and neck cancer: A contemporary review

Head and Neck - Tập 35 Số 9 - Trang 1362-1370 - 2013
Michael L. Hinni1, Alfio Ferlito2, Margaret Brandwein‐Gensler3, Robert P. Takes4, Carl E. Silver5, William H. Westra6, Raja R. Seethala7, Juan P. Rodrigo8,9, June Corry10, Carol R. Bradford11, Jennifer L. Hunt12, Primož Strojan13, Kenneth O. Devaney14, Douglas R. Gnepp15, Dana M. Hartl16,17, Luiz Paulo Kowalski18, Alessandra Rinaldo2, Leon Barnes7
1Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, AZ
2ENT Clinic, University of Udine, Udine, Italy
3Surgical Pathology Section, Division Anatomic Pathology, University of Alabama at Birmingham, Birmingham, AL
4Department of Otolaryngology-Head and Neck Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
5Departments of Surgery and Otolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY
6Departments of Pathology and Otolaryngology-Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD
7Department of Pathology and Laboratory Medicine, University of Pittsburgh, Pittsburgh, PA
8Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain
9Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
10Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
11Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI
12Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR
13Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
14Department of Pathology, Allegiance Health, Jackson, MI
15Department of Pathology, Brown University School of Medicine, Rhode Island Hospital, Providence, RI
16Department of Otolaryngology – Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France
17Laboratoire de Phonétique et de Phonologie, Sorbonne Nouvelle, Paris, France
18Department Otorhinolaryngology-Head and Neck Surgery, Centro de Tratamento e Pesquisa Hospital do Cancer A.C. Camargo, São Paulo, Brazil

Tóm tắt

Abstract

Adequate resection margins are critical to the treatment decisions and prognosis of patients with head and neck squamous cell carcinoma (HNSCC). However, there are numerous controversies regarding reporting and interpretation of the status of resection margins. Fundamental issues relating to the basic definition of margin adequacy, uniform reporting standards for margins, optimal method of specimen dissection, and the role of intraoperative frozen section evaluation, all require further clarification and standardization. Future horizons for margin surveillance offer the possible use of novel methods such as “molecular margins” and contact microscopic endoscopy, However, the limitations of these approaches need to be understood. The goal of this review was to evaluate these issues to define a more rational, standardized approach for achieving resection margin adequacy for patients with HNSCC undergoing curative resection. © 2012 Wiley Periodicals, Inc. Head Neck, 2013

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