Division of Head and Neck Oncology, Department of Otolaryngology - Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH, USA.
Ann Surg Oncol. 2019 Nov;26(12):4070-4080. doi: 10.1245/s10434-019-07645-9. Epub 2019 Aug 5.
The status of surgical margins is the most important prognosticator for patients undergoing surgical resection of head and neck squamous cell carcinoma (HNSCC). Despite this, analysis of surgical margins is fraught with inconsistencies, including the ways in which margins are sampled and interpreted. Fundamentally, even the definition what constitutes a "clear" (or negative) margin may vary between institutions, surgeons, and pathologists.
The PubMed database was queried for articles relevant to the topic, and experts in the field were consulted regarding key articles for inclusion. Abstracts were reviewed and the full text was accessed for articles of particular interest.
Data regarding various approaches to traditional margin analysis have been published without consensus. Several next-generation technologies have emerged in recent years that hold promise.
An overview and appraisal of traditional margin analysis techniques are provided. Additionally, we explore novel technologies that may assist in more accurate margin assessment, guide the extent of surgical resections intraoperatively, and inform decisions regarding adjuvant treatment postoperatively.
手术切缘的状态是接受头颈部鳞状细胞癌（HNSCC）手术切除的患者最重要的预后因素。尽管如此，手术切缘的分析存在诸多不一致之处，包括切缘取样和解释的方式。从根本上讲，即使是“清晰”（或阴性）切缘的定义，在不同的机构、外科医生和病理学家之间也可能有所不同。
在 PubMed 数据库中查询与该主题相关的文章，并就纳入的关键文章咨询该领域的专家。对摘要进行审查，并查阅全文，以获取特别感兴趣的文章。
已经发表了有关传统切缘分析各种方法的数据，但尚未达成共识。近年来出现了几种有前途的下一代技术。
提供了对传统切缘分析技术的概述和评估。此外，我们还探讨了可能有助于更准确地评估切缘、指导术中手术切除范围以及为术后辅助治疗提供决策的新技术。
