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Erschienen in: Annals of Surgical Oncology 12/2019

05.08.2019 | Head and Neck Oncology

Margin Analysis in Head and Neck Cancer: State of the Art and Future Directions

verfasst von: Michael M. Li, MD, Sidharth V. Puram, MD, PhD, Dustin A. Silverman, MD, Matthew O. Old, MD, James W. Rocco, MD, PhD, Stephen Y. Kang, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 12/2019

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Abstract

Background

The status of surgical margins is the most important prognosticator for patients undergoing surgical resection of head and neck squamous cell carcinoma (HNSCC). Despite this, analysis of surgical margins is fraught with inconsistencies, including the ways in which margins are sampled and interpreted. Fundamentally, even the definition what constitutes a “clear” (or negative) margin may vary between institutions, surgeons, and pathologists.

Methods

The PubMed database was queried for articles relevant to the topic, and experts in the field were consulted regarding key articles for inclusion. Abstracts were reviewed and the full text was accessed for articles of particular interest.

Results

Data regarding various approaches to traditional margin analysis have been published without consensus. Several next-generation technologies have emerged in recent years that hold promise.

Conclusion

An overview and appraisal of traditional margin analysis techniques are provided. Additionally, we explore novel technologies that may assist in more accurate margin assessment, guide the extent of surgical resections intraoperatively, and inform decisions regarding adjuvant treatment postoperatively.
Literatur
1.
Zurück zum Zitat Jesse RH, Sugarbaker EV. Squamous cell carcinoma of the oropharynx: why we fail. Am J Surg. 1976;132(4):435–8.CrossRefPubMed Jesse RH, Sugarbaker EV. Squamous cell carcinoma of the oropharynx: why we fail. Am J Surg. 1976;132(4):435–8.CrossRefPubMed
2.
Zurück zum Zitat Loree TR, Strong EW. Significance of positive margins in oral cavity squamous carcinoma. Am J Surg. 1990;160(4):410–4.CrossRefPubMed Loree TR, Strong EW. Significance of positive margins in oral cavity squamous carcinoma. Am J Surg. 1990;160(4):410–4.CrossRefPubMed
3.
Zurück zum Zitat Meier JD, Oliver DA, Varvares MA. Surgical margin determination in head and neck oncology: Current clinical practice. The results of an International American Head and Neck Society Member Survey. 2005;27(11):952–8. Meier JD, Oliver DA, Varvares MA. Surgical margin determination in head and neck oncology: Current clinical practice. The results of an International American Head and Neck Society Member Survey. 2005;27(11):952–8.
4.
Zurück zum Zitat McMahon J, O’Brien CJ, Pathak I, et al. Influence of condition of surgical margins on local recurrence and disease-specific survival in oral and oropharyngeal cancer. Br J Oral Maxillofac Surg. 2003;41(4):224–31.CrossRefPubMed McMahon J, O’Brien CJ, Pathak I, et al. Influence of condition of surgical margins on local recurrence and disease-specific survival in oral and oropharyngeal cancer. Br J Oral Maxillofac Surg. 2003;41(4):224–31.CrossRefPubMed
5.
Zurück zum Zitat Eldeeb H, Macmillan C, Elwell C, Hammod A. The effect of the surgical margins on the outcome of patients with head and neck squamous cell carcinoma: single institution experience. Cancer Biol Med. 2012;9(1):29–33.PubMedPubMedCentral Eldeeb H, Macmillan C, Elwell C, Hammod A. The effect of the surgical margins on the outcome of patients with head and neck squamous cell carcinoma: single institution experience. Cancer Biol Med. 2012;9(1):29–33.PubMedPubMedCentral
6.
Zurück zum Zitat Binahmed A, Nason RW, Abdoh AA. The clinical significance of the positive surgical margin in oral cancer. Oral Oncol. 2007;43(8):780–4.CrossRefPubMed Binahmed A, Nason RW, Abdoh AA. The clinical significance of the positive surgical margin in oral cancer. Oral Oncol. 2007;43(8):780–4.CrossRefPubMed
7.
Zurück zum Zitat Slaughter DP. Surgical management of intraoral cancer. Am J Roentgenol Rad Ther Nucl Med. 1955;73(4):605-10; discussion, 635–8. Slaughter DP. Surgical management of intraoral cancer. Am J Roentgenol Rad Ther Nucl Med. 1955;73(4):605-10; discussion, 635–8.
8.
Zurück zum Zitat Slaughter DP, Southwick HW, Smejkal W. Field cancerization in oral stratified squamous epithelium; clinical implications of multicentric origin. Cancer. 1953;6(5):963–8.CrossRefPubMed Slaughter DP, Southwick HW, Smejkal W. Field cancerization in oral stratified squamous epithelium; clinical implications of multicentric origin. Cancer. 1953;6(5):963–8.CrossRefPubMed
9.
Zurück zum Zitat Looser KG, Shah JP, Strong EW. The significance of “positive” margins in surgically resected epidermoid carcinomas. 1978;1(2):107–11. Looser KG, Shah JP, Strong EW. The significance of “positive” margins in surgically resected epidermoid carcinomas. 1978;1(2):107–11.
10.
Zurück zum Zitat Lane JE, Kent DE. Surgical margins in the treatment of nonmelanoma skin cancer and mohs micrographic surgery. Curr Surg. 2005;62(5):518–26.CrossRefPubMed Lane JE, Kent DE. Surgical margins in the treatment of nonmelanoma skin cancer and mohs micrographic surgery. Curr Surg. 2005;62(5):518–26.CrossRefPubMed
11.
Zurück zum Zitat Minton TJ. Contemporary Mohs surgery applications. Curr Opin Otolaryngol Head Neck Surg. 2008;16(4):376–80.CrossRefPubMed Minton TJ. Contemporary Mohs surgery applications. Curr Opin Otolaryngol Head Neck Surg. 2008;16(4):376–80.CrossRefPubMed
12.
Zurück zum Zitat Cohen DK, Goldberg DJ. Mohs micrographic surgery: past, present, and future. Dermatologic Surg. 2019;45(3):329–39.CrossRef Cohen DK, Goldberg DJ. Mohs micrographic surgery: past, present, and future. Dermatologic Surg. 2019;45(3):329–39.CrossRef
13.
Zurück zum Zitat Weinstein MC, Brodell RT, Bordeaux J, Honda K. The art and science of surgical margins for the dermatopathologist. Am J Dermatopathol. 2012;34(7):737–45.CrossRefPubMed Weinstein MC, Brodell RT, Bordeaux J, Honda K. The art and science of surgical margins for the dermatopathologist. Am J Dermatopathol. 2012;34(7):737–45.CrossRefPubMed
14.
Zurück zum Zitat Amit M, Na’ara S, Leider-Trejo L, et al. Improving the rate of negative margins after surgery for oral cavity squamous cell carcinoma: a prospective randomized controlled study. Head Neck. 2016;38 Suppl 1:E1803–9.CrossRefPubMed Amit M, Na’ara S, Leider-Trejo L, et al. Improving the rate of negative margins after surgery for oral cavity squamous cell carcinoma: a prospective randomized controlled study. Head Neck. 2016;38 Suppl 1:E1803–9.CrossRefPubMed
15.
Zurück zum Zitat Varvares MA, Walker RJ, Chiosea S. Does a specimen-based margin analysis of early tongue cancer better predict local control? Laryngoscope. 2016;126(11):2426–7.CrossRefPubMed Varvares MA, Walker RJ, Chiosea S. Does a specimen-based margin analysis of early tongue cancer better predict local control? Laryngoscope. 2016;126(11):2426–7.CrossRefPubMed
16.
Zurück zum Zitat Hinni ML, Ferlito A, Brandwein-Gensler MS, et al. Surgical margins in head and neck cancer: a contemporary review. Head Neck. 2013;35(9):1362–70.CrossRefPubMed Hinni ML, Ferlito A, Brandwein-Gensler MS, et al. Surgical margins in head and neck cancer: a contemporary review. Head Neck. 2013;35(9):1362–70.CrossRefPubMed
17.
Zurück zum Zitat Kerawala CJ, Ong TK. Relocating the site of frozen sections: is there room for improvement? Head Neck. 2001;23(3):230–2.CrossRefPubMed Kerawala CJ, Ong TK. Relocating the site of frozen sections: is there room for improvement? Head Neck. 2001;23(3):230–2.CrossRefPubMed
18.
Zurück zum Zitat Berdugo J, Thompson LDR, Purgina B, et al. Measuring depth of invasion in early squamous cell carcinoma of the oral tongue: positive deep margin, extratumoral perineural invasion, and other challenges. Head Neck Pathol. Apr 26 2018. Berdugo J, Thompson LDR, Purgina B, et al. Measuring depth of invasion in early squamous cell carcinoma of the oral tongue: positive deep margin, extratumoral perineural invasion, and other challenges. Head Neck Pathol. Apr 26 2018.
19.
Zurück zum Zitat Woolgar JA, Triantafyllou A. A histopathological appraisal of surgical margins in oral and oropharyngeal cancer resection specimens. Oral Oncol. 2005;41(10):1034–3.CrossRefPubMed Woolgar JA, Triantafyllou A. A histopathological appraisal of surgical margins in oral and oropharyngeal cancer resection specimens. Oral Oncol. 2005;41(10):1034–3.CrossRefPubMed
20.
Zurück zum Zitat Choi N, Cho JK, Lee EK, Won SJ, Kim BY, Baek CH. Transoral bisected resection for T1-2 oral tongue squamous cell carcinoma to secure adequate deep margin. Oral Oncol. 2017;73:70–6.CrossRefPubMed Choi N, Cho JK, Lee EK, Won SJ, Kim BY, Baek CH. Transoral bisected resection for T1-2 oral tongue squamous cell carcinoma to secure adequate deep margin. Oral Oncol. 2017;73:70–6.CrossRefPubMed
21.
Zurück zum Zitat Tirelli G, Boscolo Nata F, Gatto A, et al. Intraoperative margin control in transoral approach for oral and oropharyngeal cancer. Tirelli G, Boscolo Nata F, Gatto A, et al. Intraoperative margin control in transoral approach for oral and oropharyngeal cancer.
22.
Zurück zum Zitat Mayer A, Royer MC, Summerlin DJ, et al. Rapid mandible margins for intraoperative assessment. Am J Otolaryngol. 2015;36(3):324–9.CrossRefPubMed Mayer A, Royer MC, Summerlin DJ, et al. Rapid mandible margins for intraoperative assessment. Am J Otolaryngol. 2015;36(3):324–9.CrossRefPubMed
23.
Zurück zum Zitat Garcia-Donas JG, Dalton A, Chaplin I, Kranioti EF. A revised method for the preparation of dry bone samples used in histological examination: five simple steps. Homo Int Zeitschrift vergleichende Forschung Menschen. 2017;68(4):283–8. Garcia-Donas JG, Dalton A, Chaplin I, Kranioti EF. A revised method for the preparation of dry bone samples used in histological examination: five simple steps. Homo Int Zeitschrift vergleichende Forschung Menschen. 2017;68(4):283–8.
24.
Zurück zum Zitat Bilodeau EA, Chiosea S. Oral squamous cell carcinoma with mandibular bone invasion: intraoperative evaluation of bone margins by routine frozen section. Head Neck Pathol. 2011;5(3):216–20.CrossRefPubMedPubMedCentral Bilodeau EA, Chiosea S. Oral squamous cell carcinoma with mandibular bone invasion: intraoperative evaluation of bone margins by routine frozen section. Head Neck Pathol. 2011;5(3):216–20.CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Forrest LA, Schuller DE, Karanfilov B, Lucas JG. Update on intraoperative analysis of mandibular margins. Am J Otolaryngol. 1997;18(6):396–9.CrossRefPubMed Forrest LA, Schuller DE, Karanfilov B, Lucas JG. Update on intraoperative analysis of mandibular margins. Am J Otolaryngol. 1997;18(6):396–9.CrossRefPubMed
26.
Zurück zum Zitat Weisberger EC, Hilburn M, Johnson B, Nguyen C. Intraoperative microwave processing of bone margins during resection of head and neck cancer. Arch Otolaryngol Head Neck Surg. 2001;127(7):790–3.PubMed Weisberger EC, Hilburn M, Johnson B, Nguyen C. Intraoperative microwave processing of bone margins during resection of head and neck cancer. Arch Otolaryngol Head Neck Surg. 2001;127(7):790–3.PubMed
27.
Zurück zum Zitat Nieberler M, Hausler P, Drecoll E, et al. Evaluation of intraoperative cytological assessment of bone resection margins in patients with oral squamous cell carcinoma. Cancer Cytopathol. 2014;122(9):646–56.CrossRefPubMed Nieberler M, Hausler P, Drecoll E, et al. Evaluation of intraoperative cytological assessment of bone resection margins in patients with oral squamous cell carcinoma. Cancer Cytopathol. 2014;122(9):646–56.CrossRefPubMed
28.
Zurück zum Zitat Singh A, Mair M, Singhvi H, et al. Incidence, predictors and impact of positive bony margins in surgically treated T4 stage cancers of the oral cavity. Oral Oncol. 2019;90:8–12.CrossRefPubMed Singh A, Mair M, Singhvi H, et al. Incidence, predictors and impact of positive bony margins in surgically treated T4 stage cancers of the oral cavity. Oral Oncol. 2019;90:8–12.CrossRefPubMed
29.
Zurück zum Zitat Ord RA, Aisner S. Accuracy of frozen sections in assessing margins in oral cancer resection. J Oral Maxillofacial Surg. 1997;55(7):663–9.CrossRef Ord RA, Aisner S. Accuracy of frozen sections in assessing margins in oral cancer resection. J Oral Maxillofacial Surg. 1997;55(7):663–9.CrossRef
30.
Zurück zum Zitat Du E, Ow TJ, Lo YT, et al. Refining the utility and role of Frozen section in head and neck squamous cell carcinoma resection. Laryngoscope. 2016;126(8):1768–1775.CrossRefPubMed Du E, Ow TJ, Lo YT, et al. Refining the utility and role of Frozen section in head and neck squamous cell carcinoma resection. Laryngoscope. 2016;126(8):1768–1775.CrossRefPubMed
31.
Zurück zum Zitat DiNardo LJ, Lin J, Karageorge LS, Powers CN. Accuracy, utility, and cost of frozen section margins in head and neck cancer surgery. Laryngoscope. 2000;110(10 Pt 1):1773–1776.CrossRefPubMed DiNardo LJ, Lin J, Karageorge LS, Powers CN. Accuracy, utility, and cost of frozen section margins in head and neck cancer surgery. Laryngoscope. 2000;110(10 Pt 1):1773–1776.CrossRefPubMed
32.
Zurück zum Zitat Nocon CC, Ajmani GS, Bhayani MK. Association of facility volume with positive margin rate in the surgical treatment of head and neck cancerassociation of facility volume with positive margin rate in head and neck cancer surgical treatment. Association of facility volume with positive margin rate in head and neck cancer surgical treatment. JAMA Otolaryngol Head Neck Surg. 2018;144(12):1090–7. Nocon CC, Ajmani GS, Bhayani MK. Association of facility volume with positive margin rate in the surgical treatment of head and neck cancerassociation of facility volume with positive margin rate in head and neck cancer surgical treatment. Association of facility volume with positive margin rate in head and neck cancer surgical treatment. JAMA Otolaryngol Head Neck Surg. 2018;144(12):1090–7.
33.
Zurück zum Zitat Ettl T, El-Gindi A, Hautmann M, et al. Positive frozen section margins predict local recurrence in R0-resected squamous cell carcinoma of the head and neck. Oral Oncol. 2016;55:17–23.CrossRefPubMed Ettl T, El-Gindi A, Hautmann M, et al. Positive frozen section margins predict local recurrence in R0-resected squamous cell carcinoma of the head and neck. Oral Oncol. 2016;55:17–23.CrossRefPubMed
34.
Zurück zum Zitat Patel RS, Goldstein DP, Guillemaud J, et al. Impact of positive frozen section microscopic tumor cut-through revised to negative on oral carcinoma control and survival rates. Head Neck. 2010;32(11):1444–51.CrossRefPubMed Patel RS, Goldstein DP, Guillemaud J, et al. Impact of positive frozen section microscopic tumor cut-through revised to negative on oral carcinoma control and survival rates. Head Neck. 2010;32(11):1444–51.CrossRefPubMed
35.
Zurück zum Zitat Bertino G, Degiorgi G, Tinelli C, Cacciola S, Occhini A, Benazzo M. CO2 laser cordectomy for T1–T2 glottic cancer: oncological and functional long-term results. Eur Arch Oto-Rhino-Laryngol. 2015;272(9):2389–95.CrossRef Bertino G, Degiorgi G, Tinelli C, Cacciola S, Occhini A, Benazzo M. CO2 laser cordectomy for T1–T2 glottic cancer: oncological and functional long-term results. Eur Arch Oto-Rhino-Laryngol. 2015;272(9):2389–95.CrossRef
36.
Zurück zum Zitat Hendriksma M, Montagne MW, Langeveld TPM, Veselic M, van Benthem PPG, Sjögren EV. Evaluation of surgical margin status in patients with early glottic cancer (Tis-T2) treated with transoral CO(2) laser microsurgery, on local control. Eur Arch Oto-rhino-laryngol. 2018;275(9):2333–40.CrossRef Hendriksma M, Montagne MW, Langeveld TPM, Veselic M, van Benthem PPG, Sjögren EV. Evaluation of surgical margin status in patients with early glottic cancer (Tis-T2) treated with transoral CO(2) laser microsurgery, on local control. Eur Arch Oto-rhino-laryngol. 2018;275(9):2333–40.CrossRef
37.
Zurück zum Zitat Wong LS, McMahon J, Devine J, et al. Influence of close resection margins on local recurrence and disease-specific survival in oral and oropharyngeal carcinoma. Br J Oral Maxillofacial Surg. 2012;50(2):102–8.CrossRef Wong LS, McMahon J, Devine J, et al. Influence of close resection margins on local recurrence and disease-specific survival in oral and oropharyngeal carcinoma. Br J Oral Maxillofacial Surg. 2012;50(2):102–8.CrossRef
38.
Zurück zum Zitat Dillon JK, Brown CB, McDonald TM, et al. How does the close surgical margin impact recurrence and survival when treating oral squamous cell carcinoma? J Oral Maxillofacial Surg. 2015;73(6):1182–8.CrossRef Dillon JK, Brown CB, McDonald TM, et al. How does the close surgical margin impact recurrence and survival when treating oral squamous cell carcinoma? J Oral Maxillofacial Surg. 2015;73(6):1182–8.CrossRef
39.
Zurück zum Zitat Barry CP, Ahmed F, Rogers SN, et al. Influence of surgical margins on local recurrence in T1/T2 oral squamous cell carcinoma. 2015;37(8):1176–80. Barry CP, Ahmed F, Rogers SN, et al. Influence of surgical margins on local recurrence in T1/T2 oral squamous cell carcinoma. 2015;37(8):1176–80.
40.
Zurück zum Zitat Ch’ng S, Corbett-Burns S, Stanton N, et al. Close margin alone does not warrant postoperative adjuvant radiotherapy in oral squamous cell carcinoma. 2013;119(13):2427–37.PubMed Ch’ng S, Corbett-Burns S, Stanton N, et al. Close margin alone does not warrant postoperative adjuvant radiotherapy in oral squamous cell carcinoma. 2013;119(13):2427–37.PubMed
41.
Zurück zum Zitat Zanoni DK, Migliacci JC, Xu B, et al. A proposal to redefine close surgical margins in squamous cell carcinoma of the oral tongue. JAMA Otolaryngol Head Neck Surg. 2017;143(6):555–60.CrossRefPubMedPubMedCentral Zanoni DK, Migliacci JC, Xu B, et al. A proposal to redefine close surgical margins in squamous cell carcinoma of the oral tongue. JAMA Otolaryngol Head Neck Surg. 2017;143(6):555–60.CrossRefPubMedPubMedCentral
42.
Zurück zum Zitat Tasche KK, Buchakjian MR, Pagedar NA, Sperry SM. Definition of “close margin” in oral cancer surgery and association of margin distance with local recurrence rate. JAMA Otolaryngol Head Neck Surg. 2017;143(12):1166–72.CrossRefPubMedPubMedCentral Tasche KK, Buchakjian MR, Pagedar NA, Sperry SM. Definition of “close margin” in oral cancer surgery and association of margin distance with local recurrence rate. JAMA Otolaryngol Head Neck Surg. 2017;143(12):1166–72.CrossRefPubMedPubMedCentral
43.
Zurück zum Zitat Hadjipanayis CG, Widhalm G, Stummer W. What is the surgical benefit of utilizing 5-aminolevulinic acid for fluorescence-guided surgery of malignant gliomas? Neurosurgery. 2015;77(5):663–73.CrossRefPubMed Hadjipanayis CG, Widhalm G, Stummer W. What is the surgical benefit of utilizing 5-aminolevulinic acid for fluorescence-guided surgery of malignant gliomas? Neurosurgery. 2015;77(5):663–73.CrossRefPubMed
44.
Zurück zum Zitat Motekallemi A, Jeltema H-R, Metzemaekers JDM, van Dam GM, Crane LMA, Groen RJM. The current status of 5-ALA fluorescence-guided resection of intracranial meningiomas-a critical review. Neurosurg Rev. 2015;38(4):619–28.CrossRefPubMedPubMedCentral Motekallemi A, Jeltema H-R, Metzemaekers JDM, van Dam GM, Crane LMA, Groen RJM. The current status of 5-ALA fluorescence-guided resection of intracranial meningiomas-a critical review. Neurosurg Rev. 2015;38(4):619–28.CrossRefPubMedPubMedCentral
45.
Zurück zum Zitat Leunig A, Mehlmann M, Betz C, et al. Fluorescence staining of oral cancer using a topical application of 5-aminolevulinic acid: fluorescence microscopic studies. J Photochem Photobiol B. 2001;60(1):44–9.CrossRefPubMed Leunig A, Mehlmann M, Betz C, et al. Fluorescence staining of oral cancer using a topical application of 5-aminolevulinic acid: fluorescence microscopic studies. J Photochem Photobiol B. 2001;60(1):44–9.CrossRefPubMed
46.
Zurück zum Zitat Miles BA, Patsias A, Quang T, Polydorides AD, Richards-Kortum R, Sikora AG. Operative margin control with high-resolution optical microendoscopy for head and neck squamous cell carcinoma. Laryngoscope. 2015;125(10):2308–16.CrossRefPubMed Miles BA, Patsias A, Quang T, Polydorides AD, Richards-Kortum R, Sikora AG. Operative margin control with high-resolution optical microendoscopy for head and neck squamous cell carcinoma. Laryngoscope. 2015;125(10):2308–16.CrossRefPubMed
47.
Zurück zum Zitat de Boer E, Warram JM, Tucker MD, et al. In Vivo Fluorescence Immunohistochemistry: Localization of Fluorescently Labeled Cetuximab in Squamous Cell Carcinomas. Sci Rep. 2015;5:10169.CrossRefPubMedPubMedCentral de Boer E, Warram JM, Tucker MD, et al. In Vivo Fluorescence Immunohistochemistry: Localization of Fluorescently Labeled Cetuximab in Squamous Cell Carcinomas. Sci Rep. 2015;5:10169.CrossRefPubMedPubMedCentral
48.
Zurück zum Zitat Iqbal H, Pan Q. Image guided surgery in the management of head and neck cancer. Oral Oncol. 2016;57:32–9.CrossRefPubMed Iqbal H, Pan Q. Image guided surgery in the management of head and neck cancer. Oral Oncol. 2016;57:32–9.CrossRefPubMed
49.
Zurück zum Zitat Keereweer S, Kerrebijn JD, Mol IM, et al. Optical imaging of oral squamous cell carcinoma and cervical lymph node metastasis. Head Neck. 2012;34(7):1002–8.CrossRefPubMed Keereweer S, Kerrebijn JD, Mol IM, et al. Optical imaging of oral squamous cell carcinoma and cervical lymph node metastasis. Head Neck. 2012;34(7):1002–8.CrossRefPubMed
50.
Zurück zum Zitat van Driel PB, van de Giessen M, Boonstra MC, et al. Characterization and evaluation of the artemis camera for fluorescence-guided cancer surgery. Mol Imaging Biol. 2015;17(3):413–23.CrossRefPubMed van Driel PB, van de Giessen M, Boonstra MC, et al. Characterization and evaluation of the artemis camera for fluorescence-guided cancer surgery. Mol Imaging Biol. 2015;17(3):413–23.CrossRefPubMed
51.
Zurück zum Zitat Atallah I, Milet C, Coll JL, Reyt E, Righini CA, Hurbin A. Role of near-infrared fluorescence imaging in head and neck cancer surgery: from animal models to humans. Eur Arch Otorhinolaryngol. 2015;272(10):2593–600.CrossRefPubMed Atallah I, Milet C, Coll JL, Reyt E, Righini CA, Hurbin A. Role of near-infrared fluorescence imaging in head and neck cancer surgery: from animal models to humans. Eur Arch Otorhinolaryngol. 2015;272(10):2593–600.CrossRefPubMed
52.
Zurück zum Zitat Gao RW, Teraphongphom NT, van den Berg NS, et al. Determination of Tumor Margins with Surgical Specimen Mapping Using Near-Infrared Fluorescence. Cancer Res. 2018;78(17):5144–54.CrossRefPubMedPubMedCentral Gao RW, Teraphongphom NT, van den Berg NS, et al. Determination of Tumor Margins with Surgical Specimen Mapping Using Near-Infrared Fluorescence. Cancer Res. 2018;78(17):5144–54.CrossRefPubMedPubMedCentral
53.
Zurück zum Zitat van Keulen S, van den Berg NS, Nishio N, et al. Rapid, non-invasive fluorescence margin assessment: Optical specimen mapping in oral squamous cell carcinoma. Oral Oncol. 2019;88:58–65.CrossRefPubMed van Keulen S, van den Berg NS, Nishio N, et al. Rapid, non-invasive fluorescence margin assessment: Optical specimen mapping in oral squamous cell carcinoma. Oral Oncol. 2019;88:58–65.CrossRefPubMed
55.
Zurück zum Zitat Auner GW, Koya SK, Huang C, et al. Applications of Raman spectroscopy in cancer diagnosis. Cancer Metastasis Rev. Dec 19 2018. Auner GW, Koya SK, Huang C, et al. Applications of Raman spectroscopy in cancer diagnosis. Cancer Metastasis Rev. Dec 19 2018.
56.
Zurück zum Zitat Francisco AL, Correr WR, Pinto CA, et al. Analysis of surgical margins in oral cancer using in situ fluorescence spectroscopy. Oral Oncol. 2014;50(6):593–9.CrossRefPubMed Francisco AL, Correr WR, Pinto CA, et al. Analysis of surgical margins in oral cancer using in situ fluorescence spectroscopy. Oral Oncol. 2014;50(6):593–9.CrossRefPubMed
57.
Zurück zum Zitat Jermyn M, Mercier J, Aubertin K, et al. Highly accurate detection of cancer with intraoperative, label-free, multimodal optical spectroscopy. Cancer Res. 2017;77(14):3942.CrossRefPubMed Jermyn M, Mercier J, Aubertin K, et al. Highly accurate detection of cancer with intraoperative, label-free, multimodal optical spectroscopy. Cancer Res. 2017;77(14):3942.CrossRefPubMed
58.
Zurück zum Zitat St John ER, Balog J, McKenzie JS, et al. Rapid evaporative ionisation mass spectrometry of electrosurgical vapours for the identification of breast pathology: towards an intelligent knife for breast cancer surgery. Breast Cancer Res. 2017;19(1):59.CrossRefPubMedPubMedCentral St John ER, Balog J, McKenzie JS, et al. Rapid evaporative ionisation mass spectrometry of electrosurgical vapours for the identification of breast pathology: towards an intelligent knife for breast cancer surgery. Breast Cancer Res. 2017;19(1):59.CrossRefPubMedPubMedCentral
59.
Zurück zum Zitat Brennan JA, Mao L, Hruban RH, et al. Molecular assessment of histopathological staging in squamous-cell carcinoma of the head and neck. N Engl J Med. 1995;332(7):429–35.CrossRefPubMed Brennan JA, Mao L, Hruban RH, et al. Molecular assessment of histopathological staging in squamous-cell carcinoma of the head and neck. N Engl J Med. 1995;332(7):429–35.CrossRefPubMed
60.
Zurück zum Zitat Pierssens D, Borgemeester MC, van der Heijden SJH, et al. Chromosome instability in tumor resection margins of primary OSCC is a predictor of local recurrence. Oral Oncol. 2017;66:14–21.CrossRefPubMed Pierssens D, Borgemeester MC, van der Heijden SJH, et al. Chromosome instability in tumor resection margins of primary OSCC is a predictor of local recurrence. Oral Oncol. 2017;66:14–21.CrossRefPubMed
61.
Zurück zum Zitat van Houten VM, Leemans CR, Kummer JA, et al. Molecular diagnosis of surgical margins and local recurrence in head and neck cancer patients: a prospective study. Clin Cancer Res. 2004;10(11):3614–20.CrossRefPubMed van Houten VM, Leemans CR, Kummer JA, et al. Molecular diagnosis of surgical margins and local recurrence in head and neck cancer patients: a prospective study. Clin Cancer Res. 2004;10(11):3614–20.CrossRefPubMed
62.
Zurück zum Zitat Poeta ML, Manola J, Goldwasser MA, et al. TP53 mutations and survival in squamous-cell carcinoma of the head and neck. N Engl J Med. 2007;357(25):2552–61.CrossRefPubMedPubMedCentral Poeta ML, Manola J, Goldwasser MA, et al. TP53 mutations and survival in squamous-cell carcinoma of the head and neck. N Engl J Med. 2007;357(25):2552–61.CrossRefPubMedPubMedCentral
63.
Zurück zum Zitat Yang XH, Ding L, Fu Y, et al. p53-positive expression in dysplastic surgical margins is a predictor of tumor recurrence in patients with early oral squamous cell carcinoma. Cancer Manage Res. 2019;11:1465–72.CrossRef Yang XH, Ding L, Fu Y, et al. p53-positive expression in dysplastic surgical margins is a predictor of tumor recurrence in patients with early oral squamous cell carcinoma. Cancer Manage Res. 2019;11:1465–72.CrossRef
64.
Zurück zum Zitat Cruz IB, Snijders PJ, Meijer CJ, et al. p53 expression above the basal cell layer in oral mucosa is an early event of malignant transformation and has predictive value for developing oral squamous cell carcinoma. J Pathol. 1998;184(4):360–8.CrossRefPubMed Cruz IB, Snijders PJ, Meijer CJ, et al. p53 expression above the basal cell layer in oral mucosa is an early event of malignant transformation and has predictive value for developing oral squamous cell carcinoma. J Pathol. 1998;184(4):360–8.CrossRefPubMed
65.
Zurück zum Zitat Singh J, Jayaraj R, Baxi S, et al. Immunohistochemical expression levels of p53 and eIF4E markers in histologically negative surgical margins, and their association with the clinical outcome of patients with head and neck squamous cell carcinoma. Molec Clin Oncol. 2016;4(2):166–72.CrossRef Singh J, Jayaraj R, Baxi S, et al. Immunohistochemical expression levels of p53 and eIF4E markers in histologically negative surgical margins, and their association with the clinical outcome of patients with head and neck squamous cell carcinoma. Molec Clin Oncol. 2016;4(2):166–72.CrossRef
66.
Zurück zum Zitat Nathan CO, Franklin S, Abreo FW, Nassar R, De Benedetti A, Glass J. Analysis of surgical margins with the molecular marker eIF4E: a prognostic factor in patients with head and neck cancer. J Clin Oncol. 1999;17(9):2909–14.CrossRefPubMed Nathan CO, Franklin S, Abreo FW, Nassar R, De Benedetti A, Glass J. Analysis of surgical margins with the molecular marker eIF4E: a prognostic factor in patients with head and neck cancer. J Clin Oncol. 1999;17(9):2909–14.CrossRefPubMed
67.
Zurück zum Zitat Hayashi M, Wu G, Roh JL, et al. Correlation of gene methylation in surgical margin imprints with locoregional recurrence in head and neck squamous cell carcinoma. Cancer. 2015;121(12):1957–65.CrossRefPubMed Hayashi M, Wu G, Roh JL, et al. Correlation of gene methylation in surgical margin imprints with locoregional recurrence in head and neck squamous cell carcinoma. Cancer. 2015;121(12):1957–65.CrossRefPubMed
68.
Zurück zum Zitat Mao L, Clark D. Molecular margin of surgical resections–where do we go from here? Cancer. 2015;121(12):1914–6.CrossRefPubMed Mao L, Clark D. Molecular margin of surgical resections–where do we go from here? Cancer. 2015;121(12):1914–6.CrossRefPubMed
69.
Zurück zum Zitat Liu SA, Wang CC, Jiang RS, Wang WY, Lin JC. Genetic analysis of surgical margins in oral cavity cancer. Br J Surg. 2018;105(2):e142–9.CrossRefPubMed Liu SA, Wang CC, Jiang RS, Wang WY, Lin JC. Genetic analysis of surgical margins in oral cavity cancer. Br J Surg. 2018;105(2):e142–9.CrossRefPubMed
70.
Zurück zum Zitat Lin JC, Wang CC, Jiang RS, Wang WY, Liu SA. Impact of microsatellite alteration in surgical margins on local recurrence in oral cavity cancer patients. Eur Arch Otorhinolaryngol. 2017;274(1):431–9.CrossRefPubMed Lin JC, Wang CC, Jiang RS, Wang WY, Liu SA. Impact of microsatellite alteration in surgical margins on local recurrence in oral cavity cancer patients. Eur Arch Otorhinolaryngol. 2017;274(1):431–9.CrossRefPubMed
71.
Zurück zum Zitat Szukala K, Brieger J, Bruch K, et al. Loss of heterozygosity on chromosome arm 13q in larynx cancer patients: analysis of tumor, margin and clinically unchanged mucosa. Med Sci Monit. 2004;10(6):Cr233–40. Szukala K, Brieger J, Bruch K, et al. Loss of heterozygosity on chromosome arm 13q in larynx cancer patients: analysis of tumor, margin and clinically unchanged mucosa. Med Sci Monit. 2004;10(6):Cr233–40.
72.
Zurück zum Zitat Matsuzaki K, Deng G, Tanaka H, Kakar S, Miura S, Kim YS. The relationship between global methylation level, loss of heterozygosity, and microsatellite instability in sporadic colorectal cancer. 2005;11(24):8564–9. Matsuzaki K, Deng G, Tanaka H, Kakar S, Miura S, Kim YS. The relationship between global methylation level, loss of heterozygosity, and microsatellite instability in sporadic colorectal cancer. 2005;11(24):8564–9.
73.
Zurück zum Zitat Roh JL, Westra WH, Califano JA, Sidransky D, Koch WM. Tissue imprint for molecular mapping of deep surgical margins in patients with head and neck squamous cell carcinoma. Head Neck. 2012;34(11):1529–36.CrossRefPubMedPubMedCentral Roh JL, Westra WH, Califano JA, Sidransky D, Koch WM. Tissue imprint for molecular mapping of deep surgical margins in patients with head and neck squamous cell carcinoma. Head Neck. 2012;34(11):1529–36.CrossRefPubMedPubMedCentral
74.
Zurück zum Zitat Laytragoon-Lewin N, Rutqvist LE, Lewin F. DNA methylation in tumour and normal mucosal tissue of head and neck squamous cell carcinoma (HNSCC) patients: new diagnostic approaches and treatment. Med Oncol. 2013;30(3):654.CrossRefPubMed Laytragoon-Lewin N, Rutqvist LE, Lewin F. DNA methylation in tumour and normal mucosal tissue of head and neck squamous cell carcinoma (HNSCC) patients: new diagnostic approaches and treatment. Med Oncol. 2013;30(3):654.CrossRefPubMed
75.
Zurück zum Zitat Thomas GR, Nadiminti H, Regalado J. Molecular predictors of clinical outcome in patients with head and neck squamous cell carcinoma. Int J Exp Pathol. 2005;86(6):347–63.CrossRefPubMedPubMedCentral Thomas GR, Nadiminti H, Regalado J. Molecular predictors of clinical outcome in patients with head and neck squamous cell carcinoma. Int J Exp Pathol. 2005;86(6):347–63.CrossRefPubMedPubMedCentral
76.
Zurück zum Zitat Mroz EA, Tward AD, Hammon RJ, Ren Y, Rocco JW. Intra-tumor genetic heterogeneity and mortality in head and neck cancer: analysis of data from the Cancer Genome Atlas. PLoS Med. 2015;12(2):e1001786.CrossRefPubMedPubMedCentral Mroz EA, Tward AD, Hammon RJ, Ren Y, Rocco JW. Intra-tumor genetic heterogeneity and mortality in head and neck cancer: analysis of data from the Cancer Genome Atlas. PLoS Med. 2015;12(2):e1001786.CrossRefPubMedPubMedCentral
77.
Zurück zum Zitat Puram SV, Tirosh I, Parikh AS, et al. Single-cell transcriptomic analysis of primary and metastatic tumor ecosystems in head and neck cancer. Cell. 2017;171(7):1611–24.e1624.CrossRefPubMedPubMedCentral Puram SV, Tirosh I, Parikh AS, et al. Single-cell transcriptomic analysis of primary and metastatic tumor ecosystems in head and neck cancer. Cell. 2017;171(7):1611–24.e1624.CrossRefPubMedPubMedCentral
Metadaten
Titel
Margin Analysis in Head and Neck Cancer: State of the Art and Future Directions
verfasst von
Michael M. Li, MD
Sidharth V. Puram, MD, PhD
Dustin A. Silverman, MD
Matthew O. Old, MD
James W. Rocco, MD, PhD
Stephen Y. Kang, MD
Publikationsdatum
05.08.2019
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 12/2019
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-019-07645-9

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