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Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way
Published on: May 10, 2021
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What Is Important for Confirming Negative Margins When Resecting Mandibular Ameloblastomas?
Zachary S Peacock1, Yisi D Ji2, William C Faquin3
1Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA.
Summary
Intraoperative radiographs and frozen sections aid in achieving negative margins for mandibular ameloblastoma resection. A 1 cm resection margin is sufficient to prevent recurrence, with 5 mm radiographic margins achieving 83.3% accuracy.
Area of Science:
- Oral and Maxillofacial Surgery
- Oncology
- Surgical Pathology
Background:
- Ameloblastomas are odontogenic tumors requiring adequate surgical resection.
- Achieving negative margins is crucial for preventing tumor recurrence.
- Intraoperative margin assessment techniques aim to improve surgical outcomes.
Purpose of the Study:
- To evaluate the effectiveness of intraoperative radiographs and frozen sections in achieving negative margins for mandibular ameloblastoma.
- To determine the utility of these methods in preventing ameloblastoma recurrence.
Main Methods:
- Retrospective cohort study of 35 patients with mandibular ameloblastomas (2005-2015).
- Analysis of margin assessment methods: frozen section, ex vivo specimen radiograph, both, or none.
- Comparison of intraoperative margin assessment accuracy with final histopathology.
Main Results:
- No significant difference in recurrence rates was observed between different margin assessment groups.
- Radiographic margins of at least 5 mm correlated with final histologic margins of at least 5 mm in 83.3% of cases.
- One case of positive posterior bony margin occurred despite negative frozen section results.
Conclusions:
- A planned resection margin of at least 1 cm is adequate for preventing ameloblastoma recurrence.
- Intraoperative specimen radiography can provide a reliable assessment of surgical margins, with 5 mm radiographic margins achieving high accuracy.
