Smits Roeland W H, Koljenović Senada, Hardillo Jose A, Ten Hove Ivo, Meeuwis Cees A, Sewnaik Aniel, Dronkers Emilie A C, Bakker Schut Tom C, Langeveld Ton P M, Molenaar Jan, Hegt V Noordhoek, Puppels Gerwin J, Baatenburg de Jong Robert J
Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Medical Center Rotterdam, Rotterdam, The Netherlands.
Center for Optical Diagnostics and Therapy, Department of Dermatology, Erasmus University Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Head Neck. 2016 Apr;38 Suppl 1:E2197-203. doi: 10.1002/hed.24075. Epub 2015 Jun 15.
The purpose of this review was to identify publications on resection margins in oral cancer surgery and compare these with the results from 2 Dutch academic medical centers. Eight publications were considered relevant for this study, reporting 30% to 65% inadequate resection margins (ie, positive and close margins), compared to 85% in Dutch centers. However, clinical outcome in terms of overall survival and recurrence seemed comparable. The misleading difference is caused by lack of unanimous margin definition and differences in surgicopathological approaches. This prevents comparison between the centers. Data from Dutch centers showed that inadequate resection margins have a significantly negative effect on local recurrence, regional recurrence, distant metastasis, and overall survival. These results confirm the need for improvement in oral cancer surgery. We underline the need for consistent protocols and optimization of frozen section procedures. We comment on development of optical techniques for intraoperative assessment of resection margins. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2197-E2203, 2016.
本综述的目的是确定有关口腔癌手术切缘的出版物，并将其与两家荷兰学术医疗中心的结果进行比较。八项出版物被认为与本研究相关，报告的切缘不充分（即阳性和接近切缘）比例为30%至65%，而荷兰中心为85%。然而，在总生存率和复发方面的临床结果似乎具有可比性。这种误导性差异是由于切缘定义缺乏一致性以及手术病理方法的差异所致。这妨碍了各中心之间的比较。来自荷兰中心的数据表明，切缘不充分对局部复发、区域复发、远处转移和总生存率有显著负面影响。这些结果证实了口腔癌手术需要改进。我们强调需要一致的方案并优化冰冻切片程序。我们对用于术中评估切缘的光学技术的发展进行了评论。©2015威利期刊公司。《头颈》38:E2197 - E2203，2016年。
