Surgical margins in head and neck cancer: Intra- and postoperative considerations

Autor: Asterios Triantafyllou, Jennifer L. Hunt, Robert P. Takes, Michael L. Hinni, Primož Strojan, Luiz Paulo Kowalski, Vincent Vander Poorten, Juan P. Rodrigo, Michelle D. Williams, Iain J. Nixon, Carl E. Silver, Boudewijn J.M. Braakhuis, Remco de Bree, Fernando López, K. Thomas Robbins, Alessandra Rinaldo, Carlos Suárez, Alfio Ferlito
Rok vydání: 2019
Předmět:
Surgical margin
Squamous Cell Carcinoma of Head and Neck/diagnostic imaging
Review
Spectrum Analysis
Raman
Mass Spectrometry
0302 clinical medicine
Margin (machine learning)
Tumor/metabolism
Frozen Sections
Sampling (medicine)
030223 otorhinolaryngology
Tomography
Raman
Spectroscopy
Ultrasonography
Paraffin Embedding
medicine.diagnostic_test
Surgical margins
Margins of Excision
General Medicine
Molecular analysis
Head and Neck Neoplasms
030220 oncology & carcinogenesis
Radiology
Tomography
Optical Coherence
Rare cancers Radboud Institute for Health Sciences [Radboudumc 9]
medicine.medical_specialty
Fluorescence
03 medical and health sciences
Journal Article
Biomarkers
Tumor
medicine
Humans
Spectrometry
Squamous Cell Carcinoma of Head and Neck
business.industry
Spectrum Analysis
Frozen sections
Head and neck cancer
Molecular markers
Endoscopy
medicine.disease
Techniques
Clinical trial
Spectrometry
Fluorescence
Otorhinolaryngology
Optical Coherence
Biomarkers
Tumor/metabolism
Head and Neck Neoplasms/diagnostic imaging
Surgery
business
Biomarkers
Zdroj: Auris Nasus Larynx, 46, 1, pp. 10-17
Auris Nasus Larynx, 46, 10-17
Auris, Nasus, Larynx, 46(1), 10. Elsevier Ireland Ltd
ISSN: 0385-8146
Popis: Contains fulltext : 203203.pdf (Publisher’s version ) (Closed access) OBJECTIVE: To provide a perspective on the significance of recent reports for optimizing cancer free surgical margins that have challenged standard practices. METHODS: We conducted a review of the recent literature (2012-2018) using the keywords surgical margin analysis, frozen and paraffin section techniques, head and neck cancer, spectroscopy and molecular markers. RESULTS: Of significance are the reports indicating superiority of tumor specimen directed sampling of margins compared to patient directed (tumor bed) sampling for frozen section control of oral cancers. With reference to optimal distance between tumor and the surgical margin, recent reports recommended cutoffs less than 5mm. Employment of new technologies such as light spectroscopy and molecular analysis of tissues, provide opportunities for a "real time" assessment of surgical margins. CONCLUSIONS: The commonly practiced method of patient directed margin sampling involving previous studies raises concern over conclusions made regarding the efficacy of frozen section margin control. The recent studies that challenge the optimal distance for clear surgical margins are retrospective and address patient cohorts with inherently confounding factors. The use of novel ancillary techniques require further refinements, clinical trial validation, and justification based on the additional resources.
Databáze: OpenAIRE
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