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

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...

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Bibliographic Details
Published in:The Laryngoscope 2021-04, Vol.131 (4), p.782-787
Main Authors: Bulbul, Mustafa G., Zenga, Joseph, Tarabichi, Osama, Parikh, Anuraag S., Sethi, Rosh K., Robbins, K. Thomas, Puram, Sidharth V., Varvares, Mark A.
Format: Article
Language:English
Subjects:
Adult
Carcinoma, Squamous Cell - pathology
Carcinoma, Squamous Cell - surgery
Cross-Sectional Studies
Female
Frozen section
Frozen Sections
Humans
Laryngoscopy
Male
margin
Margins of Excision
Mouth Neoplasms - pathology
Mouth Neoplasms - surgery
Oral cancer
oral cavity cancer
oral cavity squamous cell carcinoma
Polls & surveys
Practice Patterns, Physicians' - statistics & numerical data
resection
Squamous cell carcinoma
survey
Surveys and Questionnaires
United States
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Summary: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
ISSN:0023-852X
1531-4995
DOI:10.1002/lary.28976