Indian Journal of Surgical Oncology

, Volume 5, Issue 3, pp 227–231 | Cite as

Site-wise Differences in Adequacy of the Surgical resection Margins in Head and Neck Cancers

  • Sivakumar Vidhyadharan
  • Indhu Augustine
  • Akshay S Kudpaje
  • Subramania Iyer
  • Krishnakumar Thankappan
Review Article

Abstract

Adequacy of surgical resection decided by the margin status is important in attaining a good local control and better survival in Head and neck Cancers. Conventionally, a measured distance between the tumor edge and the cut edge of the specimen is taken as the margin. A margin more than 5  millimeter (mm) is considered clear, less than 5 mm is close and less than one mm is denoted as involved. The concept of this adequacy varies between the different sites and subsites in head and neck. The purpose of this paper is to review the current evidence that describes the adequacy of surgical margin status and their variability among the sites and sub-sites in the head and neck.

Keywords

Head and Neck Cancers Surgical Margins Squamous cell carcinoma Oral cancer Laryngeal cancer 

References

  1. 1.
    Chan GG, Tai BC, Liang S, Lim DT, Soo KC (2002) Squamous cell carcinoma of the head and neck (HNSCC)-multi-modality treatment and impact on survival. Asian J Surg 25:35–40PubMedGoogle Scholar
  2. 2.
    Sher DJ, Thotakura V, Balboni TA, Norris CM Jr, Haddad RI, Posner MR et al (2011) Treatment of oral cavity squamous cell carcinoma with adjuvant or definitive intensity-modulated radiation therapy. Int J Radiat Oncol Biol Phys 81:215–222CrossRefGoogle Scholar
  3. 3.
    Mehra S, Shah J, Bilsky M, Selesnick S, Kraus DH (2011) Outcomes of temporal bone resection for locally advanced parotid cancer. Skull Base 21:389–396PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Yang TL, Wang CP, Ko JY, Lin CF, Lou PJ (2008) Association of tumor satellite distance with prognosis and contralateral neck recurrence of tongue squamous cell carcinoma. Head Neck 30:631–638PubMedCrossRefGoogle Scholar
  5. 5.
    Priya SR, D’Cruz AK, Pai PS (2012) Cut margins and disease control in oral cancers. J Cancer Res Ther 8:74–79PubMedCrossRefGoogle Scholar
  6. 6.
    McMahon JD, Devine JC, Hetherington J, Bryson G, McLellan D, Maciver C et al (2011) Involved surgical margins in oral and oropharyngeal carcinoma-an anatomical problem? Br J Oral Maxillofac Surg 49:172PubMedCrossRefGoogle Scholar
  7. 7.
    Fan KH, Lin CY, Kang CJ, Huang SF, Wang HM, Chen EY et al (2007) Combined-modality treatment for advanced oral tongue squamous cell carcinoma. Int J Radiat Oncol Biol Phys 67:453–461PubMedCrossRefGoogle Scholar
  8. 8.
    Yuen PW, Lam KY, Chan AC, Wei WI, Lam LK (1998) Clinicopathological analysis of local spread of carcinoma of the tongue. Am J Surg 175:242–4PubMedCrossRefGoogle Scholar
  9. 9.
    Calabrese L, Giugliano G, Bruschini R, Ansarin M, Navach V, Grosso E et al (2009) Compartmental surgery in tongue tumours: description of a new surgical technique. Acta Otorhinolaryngol Ital 29:259–64PubMedCentralPubMedGoogle Scholar
  10. 10.
    Johnson JT, Leipzig B, Cummings CW (1980) Management of T1 carcinoma of the anterior aspect of the tongue. Arch Otolaryngol 106:249–51PubMedCrossRefGoogle Scholar
  11. 11.
    Iseli TA, Lin MJ, Tsui A, Guiney A, Wiesenfeld D, Iseli CE (2012) Are wider surgical margins needed for early oral tongue cancer? J Laryngol Otol 126:289–94PubMedCrossRefGoogle Scholar
  12. 12.
    Nason RW, Sako K, Beecroft WA, Razack MS, Bakamjian VY, Shedd DP (1989) Surgical Management of Squamous cell carcinoma of the floor of mouth. Am J Surg 158:292–296PubMedCrossRefGoogle Scholar
  13. 13.
    Brown J (2003) Mechanisms of cancer invasion of the mandible. Curr Opin Otolaryngol Head Neck Surg 11:96–102PubMedCrossRefGoogle Scholar
  14. 14.
    Chen YL, Kuo SW, Fang KH, Hao SP (2011) Prognostic impact of marginal mandibulectomy in the presence of superficial bone invasion and the nononcologic outcome. Head Neck 33:708–713PubMedCrossRefGoogle Scholar
  15. 15.
    Gilbert S, Tzadik A, Leonard G (1986) Mandibular involvement by oral squamous cell carcinoma. Laryngoscope 96:96–101PubMedCrossRefGoogle Scholar
  16. 16.
    Mistry RC, Qureshi SS, Kumaran C (2005) Post-resection mucosal margin shrinkage in oral cancer: quantification and significance. J Surg Oncol 91:131–133PubMedCrossRefGoogle Scholar
  17. 17.
    Ota Y, Aoki T, Karakida K, Otsuru M, Kurabayashi H, Sasaki M et al (2009) Determination of deep surgical margin based on anatomical architecture for local control of squamous cell carcinoma of the buccal mucosa. Oral Oncol 45:605–9PubMedCrossRefGoogle Scholar
  18. 18.
    Liao CT, Huang SF, Chen IH, Chang JT, Wang HM, Ng SH et al (2008) When does skin excision allow the achievement of an adequate local control rate in patients with squamous cell carcinoma involving the buccal mucosa? Ann Surg Oncol 15:2187–2194PubMedCrossRefGoogle Scholar
  19. 19.
    Brown JS, Lowe D, Kalavrezos N, D’Souza J, Magennis P, Woolgar J (2002) Patterns of invasion and routes of tumor entry into the mandible by oral squamous cell carcinoma. Head Neck 24:370–383PubMedCrossRefGoogle Scholar
  20. 20.
    Rajapurkar M, Thankappan K, Sampathirao LM, Kuriakose MA, Iyer S (2013) Oncologic and functional outcome of the preserved eye in malignant sinonasal tumors. Head Neck 35:1379–1384PubMedGoogle Scholar
  21. 21.
    Raza SM, Garzon-Muvdi T, Gallia GL, Tamargo RJ (2012) Craniofacial resection of midline anterior skull base malignancies: a reassessment of outcomes in the modern era. World Neurosurg 78:128–136PubMedCrossRefGoogle Scholar
  22. 22.
    Schwimmer C, Weissman J, Simon AM, Janecka IP (1995) Skull Base Tumor Volume and Surgical Margins: A Pilot Study. Skull Base Surg 5:93–96PubMedCentralPubMedCrossRefGoogle Scholar
  23. 23.
    Imola MJ, Schramm VL Jr (2002) Orbital preservation in surgical management of sinonasal malignancy. Laryngoscope 112:1357–1365PubMedCrossRefGoogle Scholar
  24. 24.
    Ho CM (1997) Submucosal tumor extension in hypopharyngeal cancer. Arch Otolaryngol Head Neck Surg 123:959–965PubMedCrossRefGoogle Scholar
  25. 25.
    Ho CM, Ng WF, Lam KH, Wei WI, Yuen AP (2002) Radial clearance in resection of hypopharyngeal cancer: an independent prognostic factor. Head Neck 24:181–190PubMedCrossRefGoogle Scholar
  26. 26.
    Ferlito A, Silver CE (2001) The role of partial laryngeal resection in current management of laryngeal cancer: a collective review. Acta Otolaryngol 20:456–465Google Scholar
  27. 27.
    Remacle M, Eckel HE, Antonelli A, Brasnu D, Chevalier D, Friedrich G et al (2000) Endoscopic cordectomy. A proposal for a classification by the Working Committee, European Laryngological Society. Eur Arch Otorhinolaryngol 257:227–231PubMedCrossRefGoogle Scholar
  28. 28.
    Ansarin M (2009) Laser surgery for early glottic cancer: impact of margin status on local control and organ preservation. Arch Otolaryngol Head Neck Surg 135:385–390PubMedCrossRefGoogle Scholar
  29. 29.
    Sparano A, Chernock R, Feldman M, Laccourreye O, Brasnu D, Weinstein G (2005) Extending the inferior limits of supracricoid partial laryngectomy: a clinicopathological correlation. Laryngoscope 115:297–300PubMedCrossRefGoogle Scholar
  30. 30.
    Hassanain M, Wexler M (2010) Conservative management of well-differentiated thyroid cancer. Can J Surg 53:109–18PubMedCentralPubMedGoogle Scholar
  31. 31.
    Chan WF, Lo CY, Lam KY, Wan KY (2004) Recurrent laryngeal nerve palsy in well-differentiated thyroid carcinoma: clinicopathologic features and outcome study. World J Surg 28:1093–1098PubMedCrossRefGoogle Scholar
  32. 32.
    Brauckhoff M, Dralle H (2011) Extrathyroidal thyroid cancer: results of tracheal shaving and tracheal resection. Chirurg 82:134–140PubMedCrossRefGoogle Scholar
  33. 33.
    Nakao K, Kurozumi K (2001) Merits and demerits of operative procedure to the trachea in patients with differentiated thyroid cancer. World J Surg 25:723–727PubMedCrossRefGoogle Scholar
  34. 34.
    Shah K, Javed F, Alcock C, Shah KA, Pretorius P, Milford CA (2011) Parotid cancer treatment with surgery followed by radiotherapy in Oxford over 15 years. Ann R Coll Surg Engl 93:218–222PubMedCentralPubMedCrossRefGoogle Scholar
  35. 35.
    Ho K, Lin H, Ann DK, Chu PG, Yen Y (2011) An overview of the rare parotid gland cancer. Head Neck Oncology 3:40PubMedCentralPubMedCrossRefGoogle Scholar
  36. 36.
    Carrillo JF, Vázquez R, Ramírez-Ortega MC, Cano A, Ochoa-Carrillo FJ (2007) Multivariate Prediction of the Probability of Recurrence in Patients With Carcinoma of the Parotid Gland. Cancer 109:2043–51PubMedCrossRefGoogle Scholar

Copyright information

© Indian Association of Surgical Oncology 2014

Authors and Affiliations

  • Sivakumar Vidhyadharan
    • 1
  • Indhu Augustine
    • 1
  • Akshay S Kudpaje
    • 1
  • Subramania Iyer
    • 1
  • Krishnakumar Thankappan
    • 1
  1. 1.Department of Head and Neck Surgery and Oncology, Amrita Institute of Medical SciencesAmrita UniversityKochiIndia

Personalised recommendations