Fiona A E Smithers1,2, Georg Haymerle1,3, Carsten E Palme1, Tsu-Hui Hubert Low1, Catriona Froggatt1, Ruta Gupta1,4, Jonathan R Clark1,5. 1. Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia. 2. Department of Plastic, Reconstructive and Burns Surgery, Hutt Valley Hospital, Lower Hutt, New Zealand. 3. Department of Otorhinolaryngology - Head and Neck Surgery, Medical University of Vienna, Vienna, Austria. 4. Department of Anatomical Pathology, Royal Prince Albert Hospital, Sydney, New South Wales, Australia. 5. Department of Surgery, Royal Prince Albert Hospital, Sydney, New South Wales, Australia.
Abstract
BACKGROUND: In head and neck cancers, tumor margin assessment has important prognostic and therapeutic implications. Frozen section control of margins is commonly employed intraoperatively. However, this is not without limitations. The aim of this study is to determine whether intraoperative slicing of the whole specimen is feasible and what impact this may have on tumor margin assessment and the requirement for postoperative radiotherapy. METHODS: From September 2016 to August 2018, we recruited 22 patients as a pilot study looking at both the practicalities and the clinical relevance of whole margin tumor analysis intraoperatively. Our project is a prospective single arm study with historical controls. RESULTS: Forty-one percent of our patients required further intraoperative resection for close or involved margins. Seven of these patients who otherwise would have required adjuvant radiotherapy due to their margin status did not, after our intervention. CONCLUSIONS: We found that although requiring resources, this process was feasible without unduly increasing operative times and with potential patient benefit including reduced incidence of adjuvant radiotherapy.
BACKGROUND: In head and neck cancers, tumor margin assessment has important prognostic and therapeutic implications. Frozen section control of margins is commonly employed intraoperatively. However, this is not without limitations. The aim of this study is to determine whether intraoperative slicing of the whole specimen is feasible and what impact this may have on tumor margin assessment and the requirement for postoperative radiotherapy. METHODS: From September 2016 to August 2018, we recruited 22 patients as a pilot study looking at both the practicalities and the clinical relevance of whole margin tumor analysis intraoperatively. Our project is a prospective single arm study with historical controls. RESULTS: Forty-one percent of our patients required further intraoperative resection for close or involved margins. Seven of these patients who otherwise would have required adjuvant radiotherapy due to their margin status did not, after our intervention. CONCLUSIONS: We found that although requiring resources, this process was feasible without unduly increasing operative times and with potential patient benefit including reduced incidence of adjuvant radiotherapy.
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: Caterina Giannitto; Giuseppe Mercante; Luca Disconzi; Riccardo Boroni; Elena Casiraghi; Federica Canzano; Michele Cerasuolo; Francesca Gaino; Armando De Virgilio; Barbara Fiamengo; Fabio Ferreli; Andrea Alessandro Esposito; Paolo Oliva; Flavio Ronzoni; Luigi Terracciano; Giuseppe Spriano; Luca Balzarini Journal: Front Oncol Date: 2021-12-09 Impact factor: 6.244