Margin control in oral squamous cell carcinoma: A survey of contemporary practice in India

Chandrashekar, Chetana and Radhakrishnan, Raghu (2017) Margin control in oral squamous cell carcinoma: A survey of contemporary practice in India. Journal of Oral and Maxillofacial Surgery,Medicine,and Pathology, 29 (5). pp. 467-471.

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tBackground: Determining margin status is the key in management of oral squamous cell carcinoma,indicating risk of local recurrence and guiding the use of adjuvant therapy. Frozen sections are commonlyemployed intraoperatively to assess the adequacy of resections. There is however no standard approachas to how frozen sections are used. A practice based survey was carried out in an attempt to establishconsensus between surgeons and pathologists with regards to margin sampling and acceptable surgicalmargins.Methods: A questionnaire consisting of twelve questions was sent to surgical oncologists in various headand neck cancer centers in India. It was divided into two main subsets: 1) The definition of surgicalmargins and 2) The use of frozen sections to evaluate tumor margins.Results: Of 440 surveys mailed, 50 completed surveys were received. Majority of responses stated thatacceptable clear margins varied according to site, and individual patient factors. Macroscopically clearsurgical margins ranged between 0.5–1.5 cm. Best practice for intraoperative margin assessment wasfrozen tissue analysis of the entire specimen. The majority of responses for choice of sampling site werefor both the surgical bed and tumor margin. The overwhelming majority defined microscopically clearmargins as 5 mm of tissue or more without tumor.Conclusion: No standard guidelines and strategies exist among head and neck surgeons about the defi-nition of clear margins and the practice patterns. However, these results have to be applied on a largersample size in order to validate and authenticate our findings.

Item Type: Article
Uncontrolled Keywords: Head and neck cancer; Surgical margins; Frozen sections; Questionnaire survey
Subjects: Dentistry > MCODS Manipal > Oral Pathology and Microbiology
Depositing User: KMC Library
Date Deposited: 15 Feb 2018 03:41
Last Modified: 15 Feb 2018 03:41

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