The following is a summary of “Immediate resection of positive margins improves local control in oral tongue cancer,” published in the June 2023 issue of the Oral Oncology by Zhang et al.

This study investigates the effect of immediate resection of positive margins on oral tongue cancer local control. Researchers examined 273 consecutive cases of oral tongue carcinoma treated between 2013 and 2018. During the initial operation, additional resection was conducted in cases based on the surgeon’s examination of the specimen and frozen margins. Positive margins were defined as invasive carcinoma or high-grade dysplasia less than one millimeter from the inscribed edge. 

Negative margin (Group 1), positive margin with immediate additional tissue resection (Group 2), and positive margin without additional tissue resection (Group 3) were the patient groups. The local recurrence rate was 7.7% (21/273), while the positive primary specimen margin rate was 17.9%. 38.8% (19/49) of these patients required immediate additional resection of the presumed positive margin. After adjusting for T-stage, Group 3 had higher local recurrence rates than Group 1 (aHR = 2.8, 95% CI = 1.0–7.8, P = 0.04). Similar local recurrence rates were observed in Group 2 (aHR 0.45 [95% CI 0.06–3.6], P = 0.45). 

Three-year local recurrence-free survival was 91%, 92%, and 73% for Groups 1, 2, and 3, respectively. Compared to the central specimen margin, intraoperative frozen tumor bed margins had a sensitivity of 17.4% and a specificity of 95%. In patients with positive central specimen margins, anticipation and detection in real-time accompanied by immediate additional tissue resection decreased local recurrence to rates comparable to those of patients with negative central specimen margins. These results support the use of technology to provide intraoperative margin data in real-time and direct additional resection for enhanced local control.

Source: sciencedirect.com/science/article/abs/pii/S1368837523000982