Evaluation of correspondence between clinical and pathological margins in oral squamous cell carcinoma
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Abstract
Background: Microscopically, oral Squamous Cell Carcinoma (SCC) spreads more than the gross tumor. Thus it is recommended to resect the tumor with a proper safe margin. The aim of this study was to evaluate the correspondence between clinical and histopathological margins in oral SCC. Materials and Methods: Samples were collected from patients diagnosed with oral SCC and referred to Iran Cancer Institute in 2015. All margins of tumors were determined by a marker and then the tumors were resected with 1cm safe margin. The superior, inferior, left and right borders were marked and examined microscopically. The lowest distance between tumor cells and border of resected tissue was considered as pathological margin. The cases with pathological margin less or more than 5 millimeters were classified as close and free margin groups, respectively. Results: Forty-four specimens (20 females and 24 males), definitely diagnosed as SCC, were examined. The mean age was 61 years old. 19 cases (43.2%) were in the mandible; 23 cases (52.3%) in the tongue and 2 cases (4.5%) in the maxilla. 16 cases (38.4%) were free margin and 28 cases (63.6%) were close margin and the mean pathological margin was 3.52mm. Conclusion: For some cases, especially SCCs of the mandible, 1-centimeter margin is not adequate to achieve free margins, thus evaluating tumor location, size and stage for more resection seems worthwhile and advisable and can decrease the risk of relapse after resection. Keywords: Squamous cell carcinoma; Clinical margin; Histopathological margin.
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2. The effect of topical application of pure honey on radiation-induced mucositis: a randomised clinical trial. BDJ. 2008;205(5):257-.
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9. Hsu P-K, Huang H-C, Hsieh C-C, Hsu H-S, Wu Y-C, Huang M-H, et al. Effect of formalin fixation on tumor size determination in stage I non-small cell lung cancer. The Annals of thoracic surgery. 2007;84(6):1825-9.
10. Goldstein NS, Soman A, Sacksner J. Disparate surgical margin lengths of colorectal resection specimens between in vivo and in vitro measurements: the effects of surgical resection and formalin fixation on organ shrinkage. American journal of clinical pathology. 1999;111(3):349-51.
11. Anderson CR, Sisson K, Moncrieff M. A meta-analysis of margin size and local recurrence in oral squamous cell carcinoma. Oral oncology. 2015;51(5):464-9.
12. Girardi FM, Zanella VG, Kroef RG. Correlation between clinical and pathological data and surgical margins in patients with squamous cell carcinoma of the oral cavity. Brazilian journal of otorhinolaryngology. 2013;79(2):190-5.
13. Brandwein-Gensler M, Teixeira MS, Lewis CM, Lee B, Rolnitzky L, Hille JJ, et al. Oral squamous cell carcinoma: histologic risk assessment, but not margin status, is strongly predictive of local disease-free and overall survival. The American journal of surgical pathology. 2005;29(2):167-78.
14. Cheng A, Cox D, Schmidt BL. Oral Squamous Cell Carcinoma Margin Discrepancy After Resection and Pathologic Processing. Journal of Oral and Maxillofacial Surgery. 2008;66(3):523-9.
15. Yuen PW, Lam KY, Chan ACL, Wei WI, Lam LK. Clinicopathological analysis of local spread of carcinoma of the tongue. The American journal of surgery. 1998;175(3):242-4.
16. Tirelli G, Zacchigna S, Biasotto M, Piovesana M. Open questions and novel concepts in oral cancer surgery. European Archives of Oto-Rhino-Laryngology. 2015:1-11.
17. Upile T, Fisher C, Jerjes W, El Maaytah M, Searle A, Archer D, et al. The uncertainty of the surgical margin in the treatment of head and neck cancer. Oral oncology. 2007;43(4):321-6
Table 1. Comparison of sex and anatomic location in terms of tumor margin
Statistical test Close margin (N=38) Free margin
(N=16) Variables
P=0.670 60.50 ± 9.62 61.87 ± 11.21 Age (Mean ± SD)
P=0.647 12 (42.9%) 8 (50%) Male (%) Sex
16 (57.1%) 8 (50%) Female (%)
P=0.008 17 (60.7%) 2 (12.5%) Mandible Anatomic location
10 (35.7%) 13 (81.3%) Tongue
1 (3.6%) 1 (6.3%) Maxilla
P < 0.05 considered as statistically significant.
Table 2. Comparison of correspondence percentage between clinical and histopathological margins in terms of sex and anatomic location.
Variables Mean ± SD of correspondence percentage Statistical test
Sex Male 31.29 ± 30.42 P=0.348
Female 39.85 ± 28.98
Anatomic location Mandible 20.53 ± 23.34 P= 0.014
Tongue 46.87 ± 29.51
Maxilla 40.00 ± 42.42
P < 0.05 considered as statistically significant.
2. The effect of topical application of pure honey on radiation-induced mucositis: a randomised clinical trial. BDJ. 2008;205(5):257-.
3. Telfer MR, Shepherd JP. Psychological distress in patients attending an oncology clinic after definitive treatment for maxillofacial malignant neoplasia. International Journal of Oral and Maxillofacial Surgery. 1993;22(6):347-9.
4. Helliwell T, Woolgar J. Dataset for histopathology reporting of mucosal malignancies of the oral cavity. London: The Royal College of Pathologists. 2013.
5. Woolgar JA, Triantafyllou A. A histopathological appraisal of surgical margins in oral and oropharyngeal cancer resection specimens. Oral Oncology. 2005;41(10):1034-43.
6. Alicandri-Ciufelli M, Bonali M, Piccinini A, Marra L, Ghidini A, Cunsolo EM, et al. Surgical margins in head and neck squamous cell carcinoma: what is ‘close’? European Archives of Oto-Rhino-Laryngology. 2013;270(10):2603-9.
7. Chen T-C, Wang C-P, Ko J-Y, Yang T-L, Lou P-J. The impact of pathologic close margin on the survival of patients with early stage oral squamous cell carcinoma. Oral oncology. 2012;48(7):623-8.
8. Weijers M, Snow GB, Bezemer DP, van der Wal JE, van der Waal I. The status of the deep surgical margins in tongue and floor of mouth squamous cell carcinoma and risk of local recurrence; an analysis of 68 patients. International Journal of Oral and Maxillofacial Surgery. 2004;33(2):146-9.
9. Hsu P-K, Huang H-C, Hsieh C-C, Hsu H-S, Wu Y-C, Huang M-H, et al. Effect of formalin fixation on tumor size determination in stage I non-small cell lung cancer. The Annals of thoracic surgery. 2007;84(6):1825-9.
10. Goldstein NS, Soman A, Sacksner J. Disparate surgical margin lengths of colorectal resection specimens between in vivo and in vitro measurements: the effects of surgical resection and formalin fixation on organ shrinkage. American journal of clinical pathology. 1999;111(3):349-51.
11. Anderson CR, Sisson K, Moncrieff M. A meta-analysis of margin size and local recurrence in oral squamous cell carcinoma. Oral oncology. 2015;51(5):464-9.
12. Girardi FM, Zanella VG, Kroef RG. Correlation between clinical and pathological data and surgical margins in patients with squamous cell carcinoma of the oral cavity. Brazilian journal of otorhinolaryngology. 2013;79(2):190-5.
13. Brandwein-Gensler M, Teixeira MS, Lewis CM, Lee B, Rolnitzky L, Hille JJ, et al. Oral squamous cell carcinoma: histologic risk assessment, but not margin status, is strongly predictive of local disease-free and overall survival. The American journal of surgical pathology. 2005;29(2):167-78.
14. Cheng A, Cox D, Schmidt BL. Oral Squamous Cell Carcinoma Margin Discrepancy After Resection and Pathologic Processing. Journal of Oral and Maxillofacial Surgery. 2008;66(3):523-9.
15. Yuen PW, Lam KY, Chan ACL, Wei WI, Lam LK. Clinicopathological analysis of local spread of carcinoma of the tongue. The American journal of surgery. 1998;175(3):242-4.
16. Tirelli G, Zacchigna S, Biasotto M, Piovesana M. Open questions and novel concepts in oral cancer surgery. European Archives of Oto-Rhino-Laryngology. 2015:1-11.
17. Upile T, Fisher C, Jerjes W, El Maaytah M, Searle A, Archer D, et al. The uncertainty of the surgical margin in the treatment of head and neck cancer. Oral oncology. 2007;43(4):321-6
Table 1. Comparison of sex and anatomic location in terms of tumor margin
Statistical test Close margin (N=38) Free margin
(N=16) Variables
P=0.670 60.50 ± 9.62 61.87 ± 11.21 Age (Mean ± SD)
P=0.647 12 (42.9%) 8 (50%) Male (%) Sex
16 (57.1%) 8 (50%) Female (%)
P=0.008 17 (60.7%) 2 (12.5%) Mandible Anatomic location
10 (35.7%) 13 (81.3%) Tongue
1 (3.6%) 1 (6.3%) Maxilla
P < 0.05 considered as statistically significant.
Table 2. Comparison of correspondence percentage between clinical and histopathological margins in terms of sex and anatomic location.
Variables Mean ± SD of correspondence percentage Statistical test
Sex Male 31.29 ± 30.42 P=0.348
Female 39.85 ± 28.98
Anatomic location Mandible 20.53 ± 23.34 P= 0.014
Tongue 46.87 ± 29.51
Maxilla 40.00 ± 42.42
P < 0.05 considered as statistically significant.
| Files | ||
| Issue | Vol 9, No 4 (Autumn 2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jcr.v9i4.13383 | |
| Keywords | ||
| Squamous cell carcinoma; Clinical margin; Histopathological margin. | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Karimi A, Garajei A, Nazari H, Emami A. Evaluation of correspondence between clinical and pathological margins in oral squamous cell carcinoma. J Craniomaxillofac Res. 2023;9(4):170-175.
