Surgical margins in oral cavity squamous cell carcinoma: Current practices and future directions

Joshua J. Kain, Andrew C. Birkeland, Neha Udayakumar, Anthony B. Morlandt, Todd M. Stevens, William R. Carroll, Eben L. Rosenthal, Jason M. Warram

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

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: Systematic Reviews Laryngoscope, 2019.

Original languageEnglish (US)
JournalLaryngoscope
DOIs
StateAccepted/In press - Jan 1 2019
Externally publishedYes

Fingerprint

Frozen Sections
Mouth
Squamous Cell Carcinoma
Narrow Band Imaging
Literature
Laryngoscopes
Optical Coherence Tomography
Fluorescent Dyes
Confocal Microscopy
Disease-Free Survival
Spectrum Analysis
Coloring Agents
Survival Rate
Recurrence
Survival
Margins of Excision
Direction compound
Therapeutics

Keywords

  • frozen section
  • Oral cancer
  • squamous cell carcinoma
  • surgical margins

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Kain, J. J., Birkeland, A. C., Udayakumar, N., Morlandt, A. B., Stevens, T. M., Carroll, W. R., ... Warram, J. M. (Accepted/In press). Surgical margins in oral cavity squamous cell carcinoma: Current practices and future directions. Laryngoscope. https://doi.org/10.1002/lary.27943

Surgical margins in oral cavity squamous cell carcinoma : Current practices and future directions. / Kain, Joshua J.; Birkeland, Andrew C.; Udayakumar, Neha; Morlandt, Anthony B.; Stevens, Todd M.; Carroll, William R.; Rosenthal, Eben L.; Warram, Jason M.

In: Laryngoscope, 01.01.2019.

Research output: Contribution to journalReview article

Kain, Joshua J. ; Birkeland, Andrew C. ; Udayakumar, Neha ; Morlandt, Anthony B. ; Stevens, Todd M. ; Carroll, William R. ; Rosenthal, Eben L. ; Warram, Jason M. / Surgical margins in oral cavity squamous cell carcinoma : Current practices and future directions. In: Laryngoscope. 2019.
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