Performance of Intraoperative Assessment of Resection Margins in Oral Cancer Surgery: A Review of Literature
IntroductionAchieving adequate resection margins during oral cancer surgery is important to improve patient prognosis. Surgeons have the delicate task of achieving an adequate resection and safeguarding satisfactory remaining function and acceptable physical appearance, while relying on visual inspe...
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| Format: | Article |
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Frontiers Media S.A.
2021-03-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.628297/full |
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| author | Elisa M. Barroso Elisa M. Barroso Yassine Aaboubout Yassine Aaboubout Lisette C. van der Sar Hetty Mast Aniel Sewnaik Jose A. Hardillo Ivo ten Hove Maria R. Nunes Soares Maria R. Nunes Soares Lars Ottevanger Lars Ottevanger Tom C. Bakker Schut Gerwin J. Puppels Senada Koljenović |
| author_facet | Elisa M. Barroso Elisa M. Barroso Yassine Aaboubout Yassine Aaboubout Lisette C. van der Sar Hetty Mast Aniel Sewnaik Jose A. Hardillo Ivo ten Hove Maria R. Nunes Soares Maria R. Nunes Soares Lars Ottevanger Lars Ottevanger Tom C. Bakker Schut Gerwin J. Puppels Senada Koljenović |
| author_sort | Elisa M. Barroso |
| collection | DOAJ |
| description | IntroductionAchieving adequate resection margins during oral cancer surgery is important to improve patient prognosis. Surgeons have the delicate task of achieving an adequate resection and safeguarding satisfactory remaining function and acceptable physical appearance, while relying on visual inspection, palpation, and preoperative imaging. Intraoperative assessment of resection margins (IOARM) is a multidisciplinary effort, which can guide towards adequate resections. Different forms of IOARM are currently used, but it is unknown how accurate these methods are in predicting margin status. Therefore, this review aims to investigate: 1) the IOARM methods currently used during oral cancer surgery, 2) their performance, and 3) their clinical relevance.MethodsA literature search was performed in the following databases: Embase, Medline, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, and Google Scholar (from inception to January 23, 2020). IOARM performance was assessed in terms of accuracy, sensitivity, and specificity in predicting margin status, and the reduction of inadequate margins. Clinical relevance (i.e., overall survival, local recurrence, regional recurrence, local recurrence-free survival, disease-specific survival, adjuvant therapy) was recorded if available.ResultsEighteen studies were included in the review, of which 10 for soft tissue and 8 for bone. For soft tissue, defect-driven IOARM-studies showed the average accuracy, sensitivity, and specificity of 90.9%, 47.6%, and 84.4%, and specimen-driven IOARM-studies showed, 91.5%, 68.4%, and 96.7%, respectively. For bone, specimen-driven IOARM-studies performed better than defect-driven, with an average accuracy, sensitivity, and specificity of 96.6%, 81.8%, and 98%, respectively. For both, soft tissue and bone, IOARM positively impacts patient outcome.ConclusionIOARM improves margin-status, especially the specimen-driven IOARM has higher performance compared to defect-driven IOARM. However, this conclusion is limited by the low number of studies reporting performance results for defect-driven IOARM. The current methods suffer from inherent disadvantages, namely their subjective character and the fact that only a small part of the resection surface can be assessed in a short time span, causing sampling errors. Therefore, a solution should be sought in the field of objective techniques that can rapidly assess the whole resection surface. |
| first_indexed | 2024-12-19T08:34:14Z |
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| id | doaj.art-d456124deaff4f66b49d97404a665833 |
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| language | English |
| last_indexed | 2024-12-19T08:34:14Z |
| publishDate | 2021-03-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj.art-d456124deaff4f66b49d97404a6658332022-12-21T20:29:06ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-03-011110.3389/fonc.2021.628297628297Performance of Intraoperative Assessment of Resection Margins in Oral Cancer Surgery: A Review of LiteratureElisa M. Barroso0Elisa M. Barroso1Yassine Aaboubout2Yassine Aaboubout3Lisette C. van der Sar4Hetty Mast5Aniel Sewnaik6Jose A. Hardillo7Ivo ten Hove8Maria R. Nunes Soares9Maria R. Nunes Soares10Lars Ottevanger11Lars Ottevanger12Tom C. Bakker Schut13Gerwin J. Puppels14Senada Koljenović15Department of Pathology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Pathology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Pathology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Oral and Maxillofacial Surgery, Leiden UMC, Leiden University Medical Center, Leiden, NetherlandsDepartment of Pathology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Dermatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Pathology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Dermatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Dermatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Dermatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Pathology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsIntroductionAchieving adequate resection margins during oral cancer surgery is important to improve patient prognosis. Surgeons have the delicate task of achieving an adequate resection and safeguarding satisfactory remaining function and acceptable physical appearance, while relying on visual inspection, palpation, and preoperative imaging. Intraoperative assessment of resection margins (IOARM) is a multidisciplinary effort, which can guide towards adequate resections. Different forms of IOARM are currently used, but it is unknown how accurate these methods are in predicting margin status. Therefore, this review aims to investigate: 1) the IOARM methods currently used during oral cancer surgery, 2) their performance, and 3) their clinical relevance.MethodsA literature search was performed in the following databases: Embase, Medline, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, and Google Scholar (from inception to January 23, 2020). IOARM performance was assessed in terms of accuracy, sensitivity, and specificity in predicting margin status, and the reduction of inadequate margins. Clinical relevance (i.e., overall survival, local recurrence, regional recurrence, local recurrence-free survival, disease-specific survival, adjuvant therapy) was recorded if available.ResultsEighteen studies were included in the review, of which 10 for soft tissue and 8 for bone. For soft tissue, defect-driven IOARM-studies showed the average accuracy, sensitivity, and specificity of 90.9%, 47.6%, and 84.4%, and specimen-driven IOARM-studies showed, 91.5%, 68.4%, and 96.7%, respectively. For bone, specimen-driven IOARM-studies performed better than defect-driven, with an average accuracy, sensitivity, and specificity of 96.6%, 81.8%, and 98%, respectively. For both, soft tissue and bone, IOARM positively impacts patient outcome.ConclusionIOARM improves margin-status, especially the specimen-driven IOARM has higher performance compared to defect-driven IOARM. However, this conclusion is limited by the low number of studies reporting performance results for defect-driven IOARM. The current methods suffer from inherent disadvantages, namely their subjective character and the fact that only a small part of the resection surface can be assessed in a short time span, causing sampling errors. Therefore, a solution should be sought in the field of objective techniques that can rapidly assess the whole resection surface.https://www.frontiersin.org/articles/10.3389/fonc.2021.628297/fulloral cancersquamous cell carcinomamargin statusintraoperative assessment (IOA)specimen-drivendefect-driven |
| spellingShingle | Elisa M. Barroso Elisa M. Barroso Yassine Aaboubout Yassine Aaboubout Lisette C. van der Sar Hetty Mast Aniel Sewnaik Jose A. Hardillo Ivo ten Hove Maria R. Nunes Soares Maria R. Nunes Soares Lars Ottevanger Lars Ottevanger Tom C. Bakker Schut Gerwin J. Puppels Senada Koljenović Performance of Intraoperative Assessment of Resection Margins in Oral Cancer Surgery: A Review of Literature Frontiers in Oncology oral cancer squamous cell carcinoma margin status intraoperative assessment (IOA) specimen-driven defect-driven |
| title | Performance of Intraoperative Assessment of Resection Margins in Oral Cancer Surgery: A Review of Literature |
| title_full | Performance of Intraoperative Assessment of Resection Margins in Oral Cancer Surgery: A Review of Literature |
| title_fullStr | Performance of Intraoperative Assessment of Resection Margins in Oral Cancer Surgery: A Review of Literature |
| title_full_unstemmed | Performance of Intraoperative Assessment of Resection Margins in Oral Cancer Surgery: A Review of Literature |
| title_short | Performance of Intraoperative Assessment of Resection Margins in Oral Cancer Surgery: A Review of Literature |
| title_sort | performance of intraoperative assessment of resection margins in oral cancer surgery a review of literature |
| topic | oral cancer squamous cell carcinoma margin status intraoperative assessment (IOA) specimen-driven defect-driven |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.628297/full |
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