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Immediate resection of positive margins improves local control in oral tongue cancer.
Zhang, Lisa; Judd, Ryan T; Zhao, Songzhu; Rygalski, Chandler; Li, Michael; Briody, Ashleigh; Swendseid, Brian; Blakaj, Dukagjin M; Agrawal, Amit; Ozer, Enver; Carrau, Ricardo L; Teknos, Theodoros N; VanKoevering, Kyle; Rocco, James W; Old, Matthew O; Seim, Nolan B; Puram, Sidharth V; Haring, Catherine T; Kang, Stephen Y.
Afiliación
  • Zhang L; Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 4000 Eye and Ear Institute, 915 Olentangy River Rd, Columbus, OH 43212, USA.
  • Judd RT; Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 4000 Eye and Ear Institute, 915 Olentangy River Rd, Columbus, OH 43212, USA.
  • Zhao S; Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 4000 Eye and Ear Institute, 915 Olentangy River Rd, Columbus, OH 43212, USA.
  • Rygalski C; Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 4000 Eye and Ear Institute, 915 Olentangy River Rd, Columbus, OH 43212, USA.
  • Li M; Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 4000 Eye and Ear Institute, 915 Olentangy River Rd, Columbus, OH 43212, USA.
  • Briody A; Central Ohio Skin & Cancer, USA.
  • Swendseid B; Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 4000 Eye and Ear Institute, 915 Olentangy River Rd, Columbus, OH 43212, USA.
  • Blakaj DM; Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 4000 Eye and Ear Institute, 915 Olentangy River Rd, Columbus, OH 43212, USA.
  • Agrawal A; Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 4000 Eye and Ear Institute, 915 Olentangy River Rd, Columbus, OH 43212, USA.
  • Ozer E; Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 4000 Eye and Ear Institute, 915 Olentangy River Rd, Columbus, OH 43212, USA.
  • Carrau RL; Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 4000 Eye and Ear Institute, 915 Olentangy River Rd, Columbus, OH 43212, USA.
  • Teknos TN; Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 4000 Eye and Ear Institute, 915 Olentangy River Rd, Columbus, OH 43212, USA.
  • VanKoevering K; Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 4000 Eye and Ear Institute, 915 Olentangy River Rd, Columbus, OH 43212, USA.
  • Rocco JW; Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 4000 Eye and Ear Institute, 915 Olentangy River Rd, Columbus, OH 43212, USA.
  • Old MO; Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 4000 Eye and Ear Institute, 915 Olentangy River Rd, Columbus, OH 43212, USA.
  • Seim NB; Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 4000 Eye and Ear Institute, 915 Olentangy River Rd, Columbus, OH 43212, USA.
  • Puram SV; Department of Otolaryngology, Division of Head and Neck Surgery, Washington University School of Medicine, USA.
  • Haring CT; Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 4000 Eye and Ear Institute, 915 Olentangy River Rd, Columbus, OH 43212, USA.
  • Kang SY; Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University, 4000 Eye and Ear Institute, 915 Olentangy River Rd, Columbus, OH 43212, USA. Electronic address: Stephen.Kang@osumc.edu.
Oral Oncol ; 141: 106402, 2023 06.
Article en En | MEDLINE | ID: mdl-37094500
ABSTRACT

OBJECTIVES:

This study investigates the impact of immediate resection of positive margins on local control of oral tongue cancer. MATERIALS AND

METHODS:

We analyzed 273 consecutive oral tongue cancers resected from 2013 to 2018. Additional resection was performed in cases during the initial operation based on surgeon inspection of the specimen and/or frozen margins. Positive margins were defined as invasive carcinoma/high-grade dysplasia < 1 mm from the inked edge. Patients were grouped as follows negative margin (Group 1); positive margin with immediate additional tissue resection (Group 2); and positive margin without additional tissue resection (Group 3).

RESULTS:

Overall, the rate of local recurrence was 7.7 % (21/273), and the rate of positive main specimen margin was 17.9 %. Of these patients, 38.8 % (19/49) underwent immediate additional resection of the presumed positive margin. Group 3 had higher local recurrence rates than Group 1 after adjustment for T-stage (aHR 2.8 [95 % CI 1.0-7.7], p = 0.04). Group 2 had similar rates of local recurrence (aHR 0.45 [95 % CI 0.06-3.6], p = 0.45). Three year local recurrence free survival for Groups 1, 2, and 3 were 91 %, 92 % and 73 %, respectively. Compared to the main specimen margin, sensitivity of intraoperative frozen tumor bed margins was 17.4 %, and specificity was 95 %.

CONCLUSION:

In patients with positive main specimen margins, anticipation and detection in real-time with immediate additional tissue resection reduced local recurrence to rates similar to those with negative main specimen margins. These findings support the use of technology to provide real-time intraoperative margin data and guide additional resection for improved local control.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Neoplasias de la Boca / Neoplasias de la Lengua / Carcinoma de Células Escamosas Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Oral Oncol Asunto de la revista: NEOPLASIAS Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Neoplasias de la Boca / Neoplasias de la Lengua / Carcinoma de Células Escamosas Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Oral Oncol Asunto de la revista: NEOPLASIAS Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos