ASO Author Reflections: Margin Analysis in Head and Neck Cancer—State of the Art and Future Directions

Excerpt

The status of the surgical margin has been demonstrated to be the most important prognostic factor for patients undergoing surgical resection of head and neck squamous cell carcinoma (HNSCC) with clear or negative margins correlating with improved treatment outcomes and overall survival.1 Despite the significance of definitive tumor extirpation and obtaining negative surgical margins, a high degree of variability exists when defining what specifically constitutes a negative versus “close” margin, the amount of tissue resection required to achieve adequate margin clearance between various head and neck subsites, significance of the deep margin, and whether to perform histopathologic analysis of tissue from the primary tumor specimen or surgically resected wound bed.2 Although high rates of concordance between intraoperative frozen-section analysis and final histopathologic results exist, adjuvant treatment recommendations may be handicapped by tissue sampling bias and interpretive errors. Because the surgical margin is under surgeon control, particular attention to techniques which optimize definitive resection and negative margins are of critical importance.3 …