Back to Search
Start Over
Paradigm Change for Intraoperative Surgical Margin Assessment for Oral Squamous Cell Carcinoma.
- Source :
-
The Laryngoscope [Laryngoscope] 2024 Apr; Vol. 134 (4), pp. 1725-1732. Date of Electronic Publication: 2023 Nov 06. - Publication Year :
- 2024
-
Abstract
- Objective: Achieving clear surgical margins is one of the primary surgical goals in treating oral squamous cell carcinoma (OSCC) and thus aiming to improve overall and disease-specific survival. Therefore, we developed the Goal-Oriented Assessment for Intraoperative Margin ('GAIM') protocol, a novel intraoperative approach for margin assessment, and present here our 5-year experience and outcomes.<br />Methods: 'GAIM' is a 7-step procedure comprising systematic ruler-aided resection of labeled tumor-bed margins, frozen section (FS) co-produced by both pathologists and operating surgeons, and immediate extension of resection according to FS findings. Data from all patients operated using the 'GAIM' protocol at a single tertiary center between 2018 to 2022 were analyzed, including margin status on FS and final pathology (FP) records, recurrence, and mortality.<br />Results: A total of 196 patients were included, 56.6% (n = 111) stages I-II, and 43.4% (n = 85) stages III-IV. Using the 'GAIM' protocol, we achieved an overall 94.4% of clean and revised clean surgical margins. Patients with a 2-year and longer follow-up (n = 141) had local recurrence in 3.5% when both FS and final margins were clean, 8.1% when FP margins were clean, and 16.7% with close/positive final margins.<br />Conclusions: The proposed 'GAIM' protocol is a novel, effective, reproducible, and safe approach for margin evaluation that can be systematically applied. It can increase the rate of final clean surgical margins and potentially improve patients' outcomes.<br />Level of Evidence: 3 Laryngoscope, 134:1725-1732, 2024.<br /> (© 2023 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)
Details
- Language :
- English
- ISSN :
- 1531-4995
- Volume :
- 134
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The Laryngoscope
- Publication Type :
- Academic Journal
- Accession number :
- 37929854
- Full Text :
- https://doi.org/10.1002/lary.31126