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Related Experiment Video

Updated: Sep 1, 2025

Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way
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Measuring the margin distance in pulmonary wedge resection.

Andrea Wolf1, Daniel Laskey1, Rowena Yip2

  • 1Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Journal of Surgical Oncology
|August 17, 2022
PubMed
Summary

Surgeon measurements of tumor margins during lung cancer surgery show high consistency between repeated measures. However, surgeon and pathologist margin measurements show wide variability, impacting treatment decisions.

Keywords:
early stage NSCLCmeasurement variabilityrecurrencetumor margin distancewedge resection

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Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Pathology

Background:

  • Margin distance is crucial for survival and recurrence in early-stage non-small cell lung cancer (NSCLC) wedge resections.
  • The Initiative for Early Lung Cancer Research on Treatment aimed to standardize surgeon-measured margins during surgery.

Purpose of the Study:

  • To evaluate a novel protocol for surgeon-measured margins in NSCLC wedge resections.
  • To compare surgeon-measured margins with pathologist-measured margins.
  • To assess intraobserver and interobserver variability in margin measurements.

Main Methods:

  • Retrospective review of lung cancer patients undergoing wedge resection.
  • Standardized protocol for surgeons to measure margins twice intraoperatively.
  • Comparison of surgeon-surgeon and surgeon-pathologist margin measurements using Bland-Altman analysis.

Main Results:

  • Forty-five patients were included in the study.
  • High intraobserver reliability was found for surgeon measurements (small mean difference, narrow limit of agreement).
  • Low-to-moderate correlation and wide limits of agreement were observed between surgeon and pathologist measurements (median difference -1.0 mm, range -18.0 to 12.0 mm).

Conclusions:

  • A standardized protocol for surgeon-measured margins demonstrated high intraobserver agreement.
  • Significant variability exists between surgeon and pathologist margin measurements.
  • Standardized protocols may improve pathologic assessment consistency, with critical implications for NSCLC patient outcomes.