PURPOSE OF REVIEW: To look at the current published literature on squamous-cell carcinoma of the head and neck, at the microscopic level, and the implications of molecular and genetic research. RECENT FINDINGS: The goal of surgical treatment is still complete eradication of the primary tumour with a 'safe margin'. To achieve this 'safe margin' is not always possible, however. Currently, there is no agreed consensus as to how to submit tissue for frozen section, or how to define a 'clear margin'. Histopathologically, there are two margins requiring analysis, the mucosal margin and the 'deep margin'. Margins declared histopathologically 'tumour free' can be found to be positive for malignant/premalignant cells when molecular markers are applied. When the presence of genetically altered cells is suggested in the margins, there is an increased risk of a recurrent or new tumour. There is limited application of such knowledge and further trials are awaited. SUMMARY: Standard histopathology has limitations for examining surgical margins. The probability of recurrent malignant disease is explained and this is much increased when molecular markers are identified in the resected margins. Further studies are required.
PURPOSE OF REVIEW: To look at the current published literature on squamous-cell carcinoma of the head and neck, at the microscopic level, and the implications of molecular and genetic research. RECENT FINDINGS: The goal of surgical treatment is still complete eradication of the primary tumour with a 'safe margin'. To achieve this 'safe margin' is not always possible, however. Currently, there is no agreed consensus as to how to submit tissue for frozen section, or how to define a 'clear margin'. Histopathologically, there are two margins requiring analysis, the mucosal margin and the 'deep margin'. Margins declared histopathologically 'tumour free' can be found to be positive for malignant/premalignant cells when molecular markers are applied. When the presence of genetically altered cells is suggested in the margins, there is an increased risk of a recurrent or new tumour. There is limited application of such knowledge and further trials are awaited. SUMMARY: Standard histopathology has limitations for examining surgical margins. The probability of recurrent malignant disease is explained and this is much increased when molecular markers are identified in the resected margins. Further studies are required.
Authors: M Luana Poeta; Judith Manola; David Goldenberg; Arlene Forastiere; Joseph A Califano; John A Ridge; Jarrard Goodwin; Daniel Kenady; John Saunders; William Westra; David Sidransky; Wayne M Koch Journal: Clin Cancer Res Date: 2009-12-15 Impact factor: 12.531
Authors: Lisheng Ge; Dejan Baskic; Per Basse; Lazar Vujanovic; Sebnem Unlu; Toshie Yoneyama; Andrea Vujanovic; Jie Han; Dragic Bankovic; Miroslaw J Szczepanski; Jennifer L Hunt; Ronald B Herberman; Susanne M Gollin; Robert L Ferris; Theresa L Whiteside; Eugene N Myers; Nikola L Vujanovic Journal: Cancer Epidemiol Biomarkers Prev Date: 2009-10-20 Impact factor: 4.254
Authors: David L Masica; Shuli Li; Christopher Douville; Judith Manola; Robert L Ferris; Barbara Burtness; Arlene A Forastiere; Wayne M Koch; Christine H Chung; Rachel Karchin Journal: Hum Genet Date: 2014-08-10 Impact factor: 4.132
Authors: Anders Christensen; Katalin Kiss; Giedrius Lelkaitis; Karina Juhl; Morten Persson; Birgitte Wittenborg Charabi; Jann Mortensen; Julie Lyng Forman; Anne Lyngholm Sørensen; David Hebbelstrup Jensen; Andreas Kjaer; Christian von Buchwald Journal: BMC Cancer Date: 2017-08-25 Impact factor: 4.430