A New Proposal for Adequate Resection Margins in Larynx and Hypopharynx Tumor Surgery-Are the RCP Guidelines Feasible?

Resection margins are an important prognostic factor for patients with head and neck cancer. In general, for head and neck surgery, a margin >5 mm is advised by the Royal College of Pathologists. However, this cannot always be achieved during laryngeal and hypopharyngeal surgery. The aim of this...

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Bibliographic Details
Published in:Cancers 2024-05, Vol.16 (11), p.2058
Main Authors: Bernard, Simone E, van Lanschot, Cornelia G F, Hardillo, Jose A, Monserez, Dominiek A, Meeuwis, Cees A, Baatenburg de Jong, Robert J, Koljenović, Senada, Sewnaik, Aniel
Format: Article
Language:English
Subjects:
Anatomy
Care and treatment
Cartilage
Esophagus
Head & neck cancer
Head and neck
Hypopharynx
Laryngeal cancer
Laryngectomy
Larynx
Medical prognosis
Methods
Pharyngectomy
Practice guidelines (Medicine)
Sinuses
Squamous cell carcinoma
Surgeons
Surgery
Throat cancer
Thyroid gland
Tongue
Tumors
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Summary:Resection margins are an important prognostic factor for patients with head and neck cancer. In general, for head and neck surgery, a margin >5 mm is advised by the Royal College of Pathologists. However, this cannot always be achieved during laryngeal and hypopharyngeal surgery. The aim of this study is to identify the resection surfaces and measure the maximum feasible margins per subsite. The clinical relevance of these maximum feasible resection margins were analyzed in this descriptive anatomical study. head and neck surgeons and a pathologist from the Erasmus MC performed a total laryngectomy and laryngopharyngectomy on a head and neck specimen specifically available for research. For a total laryngectomy, resection margins >5 mm were not feasible for the ventral and dorsal resection surface. For a total laryngopharyngectomy, resection margins >5 mm were not feasible for the ventral, dorsal and lateral resection surface. Clear resection margins, defined as a margin >5 mm, are not always feasible in laryngeal and hypopharyngeal surgery, due to the anatomy of the larynx and tumor location. However, striving for a maximum feasible margin is still the main goal. We propose a new guideline for maximum feasible but adequate resection margins in larynx and hypopharynx tumor surgery.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers16112058