Mustafa G Bulbul1, Joseph Zenga2, Osama Tarabichi3, Anuraag S Parikh4, Rosh K Sethi5, K Thomas Robbins6, Sidharth V Puram7, Mark A Varvares8. 1. Department of Otolaryngology-Head and Neck Surgery, West Virginia University School of Medicine, Morgantown, West Virginia, U.S.A. 2. Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A. 3. Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, U.S.A. 4. Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A. 5. Division of Otolaryngology-Head and Neck Surgery, Brigham and Women's Hospital, Boston, Massachusetts, U.S.A. 6. Department of Otolaryngology-Head and Neck Surgery, Southern Illinois University Medical School, Springfield, Illinois, U.S.A. 7. Department of Otolaryngology-Head and Neck Surgery and Department of Genetics, Washington University School of Medicine, St. Louis, Missouri, U.S.A. 8. Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, U.S.A.
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.
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.
Authors: Alice C Yu; David D Afework; Jeffrey D Goldstein; Elliot Abemayor; Abie H Mendelsohn Journal: JAMA Otolaryngol Head Neck Surg Date: 2022-09-22 Impact factor: 8.961
Authors: Mustafa G Bulbul; Osama Tarabichi; Anuraag S Parikh; Byung C Yoon; Amy Juliano; Peter M Sadow; William Faquin; Matthew Gropler; Ronald Walker; Sidharth V Puram; Mark A Varvares Journal: Oral Oncol Date: 2021-09-23 Impact factor: 5.972
Authors: James Fowler; Yael Campanile; Andrew Warner; Francisco Laxague; Naif Fnais; Kevin Fung; Adrian Mendez; Danielle MacNeil; John Yoo; David Palma; Anthony Nichols Journal: J Otolaryngol Head Neck Surg Date: 2022-10-04