Margin Practices in Oral Cavity Cancer Resections: Survey of American Head and Neck Society Members. (22nd August 2020)

• Record Type: Journal Article
• Authors: Bulbul, Mustafa G.; Zenga, Joseph; Tarabichi, Osama; Parikh, Anuraag S.; Sethi, Rosh K.; Robbins, K. Thomas; Puram, Sidharth V.; Varvares, Mark A.
• Is Part Of: Laryngoscope. Volume 131:Number 4(2021)
• Page Start: 782
• Page End: 787
• Publication Date: 2020-08-22
• Subjects: Frozen section -- margin -- oral cavity squamous cell carcinoma -- oral cavity cancer -- resection -- survey; Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.28976
• Languages: English
• ISSNs: 0023-852X

Abstract

Abstract : Objectives/Hypothesis: To investigate the definition of a clear margin and the use of frozen section (FS) among practicing head and neck surgeons in oral cancer management. Study Design: Cross‐sectional survey. Methods: We designed a survey that was sent to American Head and Neck Society (AHNS) members via an email link. Results: A total of 185 (13% of 1, 392) AHNS members completed our survey. Most surgeons surveyed (96.8%) use FS to supplement oral cavity squamous cell carcinoma resections. Fifty‐five percent prefer a specimen‐based approach. The majority of respondents believe FS is efficacious in guiding re‐resection of positive margins, with 81% considering the new margin to be negative. More than half of respondents defined a distance of >5 mm on microscopic examination as a negative margin. Conclusions: To avoid oral cancer resections that result in positive margins on final analysis, and thus the need for additional therapy, most surgeons surveyed use FS. A majority of surveyed surgeons now prefer a specimen‐based approach to margin assessment. Although there is a debate on what constitutes a negative margin, most surgeons surveyed believe it to be >5 mm on microscopic examination. Level of Evidence: 4 Laryngoscope, 131:782–787, 2021