Scientific Publications Database

Article Title: Improving margin revision: Characterization of tumor bed margins in early oral tongue cancer
Authors: Prabhu, Arpan V.; Sturgis, Charles D.; Lai, Chi; Maxwell, Jessica H.; Merzianu, Mihai; Hernandez-Prera, Juan C.; Purgina, Bibianna; Thompson, Lester D. R.; Tuluc, Madalina; Yang, Xiu; Seethala, Raja R.; Ferris, Robert L.; Chiosea, Simion I.
Journal: ORAL ONCOLOGY Volume 75
Date of Publication:2017
Abstract:
Objectives: To improve margin revision, this study characterizes the number, fragmentation, and orientation of tumor bed margins (TBM) in patients with pT1-2 pN0 squamous cell carcinoma (SCC) of the oral tongue.Materials and Methods: Pathology reports (n = 346) were reviewed. TBM parameters were indexed. In Group 1 patients all margins were obtained from the glossectomy specimen and there were no TBM. In Revision Group/ Group 2 (n = 103), tumor bed was sampled to revise suboptimal margins identified by examination of the glossectomy specimen. In Group 3 (n= 124), TBM were obtained before examination of the glossectomy specimen.Results and Conclusions: Fewer TBMs were obtained per patient in Group 2 compared to Group 3 (57/103, 55% of patients with < 3 vs. 117/124, 94%, >= 3 TBMs, respectively). The new margin surface was more frequently indicated in Group 2 compared to Group 3 (59/103, 57%, vs. 19/124, 15%, p < .001). If glossectomy specimen margins are accepted as the reference standard, then the TBM was 15% sensitive in Group 2 (95% confidence interval [CI], 7-29) and 32% sensitive in Group 3 (95% CI, 15-55). TBM fragmentation (23/103, 22% vs. 42/124, 34%) and frozen vs. permanent discrepancies (8/103, 3% vs. 3/124, 2%) were similar between Groups 2 and 3. The new margin surface was not indicated in 6 of 11 cases with discrepant frozen vs. permanent pathology findings, precluding judgment on final margin status. To facilitate the assessment of final margins, TBM should be represented by one tissue fragment with a marked new margin surface.