Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2019

Open Access 01-12-2019 | Research article

A novel integrated platform for the identification of surgical margins in oral squamous cell carcinoma: results from a prospective single-institution series

Authors: Alessandro Baj, Nicola Fusco, Alessandro Bolzoni, Daniela Carioli, Camilla Mazzucato, Alice Faversani, Lorenzo Bresciani, Marco Maggioni, Pasquale Capaccio

Published in: BMC Cancer | Issue 1/2019

Login to get access

Abstract

Background

The optimal surgical margins assessment is capital in oral squamous cell carcinoma (OSCC) management. We evaluated the clinical benefits of integrating intraoperative macroscopic margin (MM) assessment and narrow band imaging (NBI).

Methods

Sixteen OSCC patients eligible for surgery were prospectively enrolled. For each patient, 2 to 6 bioptic samples of MM and NBI margins were obtained and histologically analyzed for the presence of dysplasia and lymphocytes. Microvessel density was investigated by CD34 immunohistochemistry.

Results

Taken together, 104 specimens were analyzed, including 15% tumors, 33% MM, 33% NBI margins, and 19% MM-NBI overlapping margins. The NBI margins were closer to the lesion in 50% cases, while the same number of MM were more conservative than NBI, irrespective of the tumor site. The rate of histologically positive margins was similar among the two methods, akin to the microvessel density.

Conclusions

MM assessment should be integrated but not replaced with the NBI technology to allow for more conservative surgery.
Literature
1.
Marur S, Forastiere AA. Head and neck squamous cell carcinoma: update on epidemiology, diagnosis, and treatment. Mayo Clin Proc. 2016;91(3):386–96.CrossRef
2.
Edge SB, Compton CC. The American joint committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol. 2010;17(6):1471–4.CrossRef
3.
Garavello W, Bertuccio P, Levi F, et al. The oral cancer epidemic in central and eastern Europe. Int J Cancer. 2010;127(1):160–71.CrossRef
4.
Adelstein D, Gillison ML, Pfister DG, et al. NCCN guidelines insights: head and neck cancers, version 2. J Natl Compr Canc Netw. 2017;15(6):761–70.CrossRef
5.
Shah AK. Postoperative pathologic assessment of surgical margins in oral cancer: a contemporary review. J Oral Maxillofac Pathol. 2018;22(1):78–85.PubMedPubMedCentral
6.
Loree TR, Strong EW. Significance of positive margins in oral cavity squamous carcinoma. Am J Surg. 1990;160(4):410–4.CrossRef
7.
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.CrossRef
8.
Tirelli G, Zacchigna S, Boscolo Nata F, Quatela E, Di Lenarda R, Piovesana M. Will the mininvasive approach challenge the old paradigms in oral cancer surgery? Eur Arch Otorhinolaryngol. 2017;274(3):1279–89.CrossRef
9.
Tirelli G, Piovesana M, Gatto A, Tofanelli M, Biasotto M, Boscolo Nata F. Narrow band imaging in the intra-operative definition of resection margins in oral cavity and oropharyngeal cancer. Oral Oncol. 2015;51(10):908–13.CrossRef
10.
Tirelli G, Piovesana M, Gatto A, Torelli L, Di Lenarda R, Boscolo Nata F. NBI utility in the pre-operative and intra-operative assessment of oral cavity and oropharyngeal carcinoma. Am J Otolaryngol. 2017;38(1):65–71.CrossRef
11.
Jalayer Naderi N, Tirgari F, Keshavarz Z. Vascular endothelial growth factor expression and vascular density in oral squamous cell carcinoma (OSCC): a study on clinical and histopathologic significance. Med J Islam Repub Iran. 2016 Apr 18;30:358.PubMedPubMedCentral
12.
Weidner N, Semple JP, Welch WR, Folkman J. Tumor angiogenesis and metastasis--correlation in invasive breast carcinoma. N Engl J Med. 1991;324(1):1–8.CrossRef
13.
Ingaleshwar PS, Pandit S, Desai D, Redder CP, Shetty AS, Mithun KM. Immunohistochemical analysis of angiogenesis by CD34 and mast cells by toluidine blue in different grades of oral squamous cell carcinoma. J Oral Maxillofac Pathol. 2016;20(3):467–73.CrossRef
14.
Williams MD. Determining adequate margins in head and neck cancers: practice and continued challenges. Curr Oncol Rep. 2016;18(9):54.CrossRef
15.
General Assembly of the World Medical Association. World medical association declaration of Helsinki: ethical principles for medical research involving human subjects. J Am Coll Dent. 2014 Summer;81(3):14–8.
16.
Amin MB, Edge SB, Greene FL, et al. AJCC Cancer staging manual. Eighth ed. New York, NY: Springer; 2017.CrossRef
17.
Klauschen F, Müller KR, Binder A, et al. International scoring of tumor-infiltrating lymphocytes: from visual estimation to machine learning. Semin Cancer Biol. 2018;52(Pt 2):151-157.
18.
Ercoli G, Lopez G, Ciapponi C, et al. Building Up a High-throughput Screening Platform to Assess the Heterogeneity of HER2 Gene Amplification in Breast Cancers. J Vis Exp. 2017;5(130).
19.
Sciarra A, Lopez G, Corti C, et al. Columnar cell lesion and apocrine hyperplasia of the breast: is there a common origin? The role of prolactin-induced protein. Appl Immunohistochem Mol Morphol. 2017 Oct 27.
20.
Fusco N, Guerini-Rocco E, Del Gobbo A, et al. The contrasting role of p16Ink4A patterns of expression in neuroendocrine and non-neuroendocrine lung tumors: a comprehensive analysis with Clinicopathologic and molecular correlations. PLoS One. 2015;10(12):e0144923.CrossRef
21.
Fusco N, Lopez G, Corti C, et al. Mismatch repair protein loss as a prognostic and predictive biomarker regardless of microsatellite instability. JNCI Cancer Spectrum. 2018 Nov;4(2):pky056.
22.
Szafarowski T, Sierdzinski J, Szczepanski MJ, Whiteside TL, Ludwig N, Krzeski A. Microvessel density in head and neck squamous cell carcinoma. Eur Arch Otorhinolaryngol. 2018;275(7):1845–51.CrossRef
23.
Piazza C, Del Bon F, Paderno A, et al. The diagnostic value of narrow band imaging in different oral and oropharyngeal subsites. Eur Arch Otorhinolaryngol. 2016;273(10):3347–53.CrossRef
24.
Irimie AI, Braicu C, Cojocneanu-Petric R, Berindan-Neagoe I, Campian RS. Novel technologies for oral squamous carcinoma biomarkers in diagnostics and prognostics. Acta Odontol Scand. 2015;73(3):161–8.CrossRef
25.
Retzbach EP, Sheehan SA, Nevel EM, et al. Podoplanin emerges as a functionally relevant oral cancer biomarker and therapeutic target. Oral Oncol. 2018;78:126–36.CrossRef
26.
Song W, Sun Y, Lin J, Bi X. Current research on head and neck cancer-associated long noncoding RNAs. Oncotarget. 2017;9(1):1403–25.PubMedPubMedCentral
27.
Sinha P, Bahadur S, Thakar A, et al. Significance of promoter hypermethylation of p16 gene for margin assessment in carcinoma tongue. Head Neck. 2009;31(11):1423–30.CrossRef
28.
Tirelli G, Piovesana M, Marcuzzo AV, et al. Tailored resections in oral and oropharyngeal cancer using narrow band imaging. Am J Otolaryngol. 2018;39(2):197–203.CrossRef
29.
Poh CF, Zhang L, Anderson DW, et al. Fluorescence visualization detection of field alterations in tumor margins of oral cancer patients. Clin Cancer Res. 2006;12(22):6716–22.CrossRef
30.
Tirelli G, Piovesana M, Gatto A, Torelli L, Boscolo Nata F. Is NBI-guided resection a breakthrough for achieving adequate resection margins in Oral and oropharyngeal squamous cell carcinoma? Ann Otol Rhinol Laryngol. 2016;125(7):596–601.CrossRef
31.
Naderi NJ, Tirgari F, Keshavarz Z. Vascular endothelial growth factor expression and vascular density in oral squamous cell carcinoma (OSCC): a study on clinical and histopathologic significance. Med J Islam Repub Iran. 2016;30(1):1–6.
32.
Albo D, Granick M, Jhala N, Atkinson B, Solomon MP. The relationship of angiogenesis to biological activity in human squamous cell carcinomas of the head and neck. Ann Plast Surg. 1994;32(6):588–94.CrossRef
33.
Ascani G, Balercia P, Messi M. Lupi et al. Angiogenesis in oral squamous cell carcinoma. Acta Otorhinolaryngol Ital. 2005;25(1):13–7.PubMedPubMedCentral
34.
Shivamallappa SM, Venkatraman NT, Shreedhar B, Mohanty L, Shenoy S. Role of angiogenesis in oral squamous cell carcinoma development and metastasis: an immunohistochemical study. Int J Oral Sci. 2011;3(4):216–24.CrossRef
35.
Li SH, Hung PH, Chou KC, Hsieh SHSY. Tumor angiogenesis in oral squamous cell carcinomas: the significance of endothelial markers and hotspot selection. J Med Sci. 2009;29:67–74.
36.
Lei Y, Xie Y, Tan YS, et al. Telltale tumor infiltrating lymphocytes (TIL) in oral, head & neck cancer. Oral Oncol. 2016;61:159–65.CrossRef
37.
Wolf GT, Chepeha DB, Bellile E, Nguyen A, Thomas D, McHugh J. University of Michigan head and neck SPORE program. Tumor infiltrating lymphocytes (TIL) and prognosis in oral cavity squamous carcinoma: a preliminary study. Oral Oncol. 2015;51(1):90–5.CrossRef
Metadata
Title
A novel integrated platform for the identification of surgical margins in oral squamous cell carcinoma: results from a prospective single-institution series
Authors
Alessandro Baj
Nicola Fusco
Alessandro Bolzoni
Daniela Carioli
Camilla Mazzucato
Alice Faversani
Lorenzo Bresciani
Marco Maggioni
Pasquale Capaccio
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2019
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-019-5634-0

Other articles of this Issue 1/2019

BMC Cancer 1/2019 Go to the issue

Research article

BRCA germline mutation test for all woman with ovarian cancer?

Research article

Trastuzumab use in older patients with HER2-positive metastatic breast cancer: outcomes and treatment patterns in a whole-of-population Australian cohort (2003–2015)

Study protocol

First-line single-agent panitumumab in frail elderly patients with wild-type RAS unresectable colorectal cancer: a phase II study protocol OGSG 1602

Research article

The prognostic relevance of FOXA1 and Nestin expression in breast cancer metastases: a retrospective study of 164 cases during a 10-year period (2004–2014)

Research article

Probabilistic modeling of personalized drug combinations from integrated chemical screen and molecular data in sarcoma

Research article

Analysis of the transcriptomic features of microsatellite instability subtype colon cancer
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits