Original Report

Margin Practices in Oral Cavity Cancer Resections: Survey of American Head and Neck Society Members

Mustafa G. Bulbul MD

Department of Otolaryngology–Head and Neck Surgery, West Virginia University School of Medicine, Morgantown, West Virginia, U.S.A.

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Joseph Zenga MD,

Joseph Zenga MD

orcid.org/0000-0003-1565-9628

Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.

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Osama Tarabichi MD,

Osama Tarabichi MD

orcid.org/0000-0002-1295-8908

Department of Otolaryngology–Head and Neck Surgery, University of Iowa, Iowa City, Iowa, U.S.A.

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Anuraag S. Parikh MD,

Anuraag S. Parikh MD

orcid.org/0000-0003-0968-1028

Department of Otolaryngology–Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.

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Rosh K. Sethi MD, MPH,

Rosh K. Sethi MD, MPH

orcid.org/0000-0002-1508-1363

Division of Otolaryngology–Head and Neck Surgery, Brigham and Women's Hospital, Boston, Massachusetts, U.S.A.

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K. Thomas Robbins MD,

K. Thomas Robbins MD

Department of Otolaryngology–Head and Neck Surgery, Southern Illinois University Medical School, Springfield, Illinois, U.S.A.

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Sidharth V. Puram MD, PhD,

Sidharth V. Puram MD, PhD

Department of Otolaryngology–Head and Neck Surgery and Department of Genetics, Washington University School of Medicine, St. Louis, Missouri, U.S.A.

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Mark A. Varvares MD, FACS,

Corresponding Author

Mark A. Varvares MD, FACS

[email protected]

orcid.org/0000-0002-6570-5672

Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, U.S.A.

Send correspondence to Mark A. Varvares, MD, FACS, 243 Charles Street, Boston, MA 02114. E-mail: [email protected]

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Mustafa G. Bulbul MD,

Mustafa G. Bulbul MD

Department of Otolaryngology–Head and Neck Surgery, West Virginia University School of Medicine, Morgantown, West Virginia, U.S.A.

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Joseph Zenga MD,

Joseph Zenga MD

orcid.org/0000-0003-1565-9628

Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.

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Osama Tarabichi MD,

Osama Tarabichi MD

orcid.org/0000-0002-1295-8908

Department of Otolaryngology–Head and Neck Surgery, University of Iowa, Iowa City, Iowa, U.S.A.

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Anuraag S. Parikh MD,

Anuraag S. Parikh MD

orcid.org/0000-0003-0968-1028

Department of Otolaryngology–Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.

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Rosh K. Sethi MD, MPH,

Rosh K. Sethi MD, MPH

orcid.org/0000-0002-1508-1363

Division of Otolaryngology–Head and Neck Surgery, Brigham and Women's Hospital, Boston, Massachusetts, U.S.A.

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K. Thomas Robbins MD,

K. Thomas Robbins MD

Department of Otolaryngology–Head and Neck Surgery, Southern Illinois University Medical School, Springfield, Illinois, U.S.A.

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Sidharth V. Puram MD, PhD,

Sidharth V. Puram MD, PhD

Department of Otolaryngology–Head and Neck Surgery and Department of Genetics, Washington University School of Medicine, St. Louis, Missouri, U.S.A.

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Mark A. Varvares MD, FACS,

Corresponding Author

Mark A. Varvares MD, FACS

[email protected]

orcid.org/0000-0002-6570-5672

Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, U.S.A.

Send correspondence to Mark A. Varvares, MD, FACS, 243 Charles Street, Boston, MA 02114. E-mail: [email protected]

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First published: 22 August 2020

https://doi.org/10.1002/lary.28976

Citations: 34

Editor's Note: This Manuscript was accepted for publication on July 10, 2020.

The authors have no funding, financial relationships, or conflicts of interest to disclose.

Drs Varvares and Puram are co-corresponding authors.

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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

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Volume131, Issue4

April 2021

Pages 782-787

Margin Practices in Oral Cavity Cancer Resections: Survey of American Head and Neck Society Members

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusions

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

Information

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Margin Practices in Oral Cavity Cancer Resections: Survey of American Head and Neck Society Members

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusions

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

Related

Information