Clinicopathological study of surgical margins in squamous cell carcinoma of buccal mucosa
- PMID: 29204544
- PMCID: PMC5698506
- DOI: 10.1016/j.wjorl.2016.02.003
Clinicopathological study of surgical margins in squamous cell carcinoma of buccal mucosa
Abstract
Objective: To evaluate the margins of resected specimen of oral squamous cell carcinoma (SCC) and to document the surgical margin (measured at the time of resection) and margins at the time of pathological examination (after immersion of the specimen in formalin).
Methods: Patients who were diagnosed and confirmed with squamous carcinoma of buccal mucosa were included in the study. Patients underwent resection of the tumor with a margin of 1 cm. Soon after resection, the distance between outermost visible margin of the tumor and the margin of the specimen was measured and documented. Specimens were fixed in 10% formalin and submitted for gross and histopathological examination. The closest histopathologic margin was compared with the in situ margin (10 mm) to determine and document any shrinkage of the margin and the percentage of discrepancy if any.
Results: A total of 52 specimens were collected from patients between January 2014 and December 2014. All specimens were obtained from the oral cavity (n = 52) of which 43 (82.7%) were squamous cell carcinoma and 9 (17.3%) were verrucous variant of squamous cell carcinoma. The average decrease in tumor margins measured after fixation in formalin was found to be statistically significant (P < 0.05) in 65% of cases.
Conclusion: Tumor margin shrinks significantly after formalin fixation by about 25%. The operating surgeon and pathologist should be well aware of such changes while planning for further management thereby ensuring adequate margin of resection and adjuvant treatment wherever required to prevent possible local recurrence of the disease.
Keywords: Formalin fixation; Margin of resection; Oral squamous cell carcinoma; Recurrence.
References
-
- Shah J.P., Cendon R.A., Farr H.W., Strong E.W. Carcinoma of the oral cavity. Factors affecting treatment failure at the primary site and neck. Am J Surg. 1976;132:504–507. - PubMed
-
- Edge S.B., Byrd D.R., Compton C.C., Fritz A.G., Greene F.L., Trotti A. 7th ed. Springer; Chicago, IL: 2009. AJCC Cancer Staging Manual.
-
- Nason R.W., Binahmed A., Pathak K.A., Abdoh A.A., Sandor G.K. What is the adequate margin of surgical resection in oral cancer? Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107:625–629. - PubMed
-
- Lee J.G. Detection of residual carcinoma of the oral cavity, oropharynx, hypopharynx, and larynx: a study of surgical margins. Trans Am Acad Ophthalmol Otolaryngol. 1974;78:49–53. - PubMed
-
- Weijers M., Snow G.B., Bezemer D.P., van dr Wal J.E., 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. Int J Oral Maxillofac Surg. 2004;33:146–149. - PubMed
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