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Updated: Jul 8, 2025
Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way
Published on: May 10, 2021
Clinical Observation or Further Excision: A Retrospective Review of Margin-positive Squamous and Basal Cell
Bailey Alkhatib1, Alexandria Waler2, Madelyn Welch1
1From the University of South Carolina School of Medicine Columbia, Columbia, S.C.
Background:
Patients determined to have margin-positive nonmelanoma skin cancer (NMSC) after initial shave or punch biopsy performed by a primary care physician or dermatologist are commonly referred to extirpative surgeons for definitive removal. Not infrequently, the residual tumor is not appreciable, and the exact location of the lesion is indiscernible. The consulting surgeon must decide to excise the presumed lesion or clinically monitor for recurrence.
Methods:
This single-center, retrospective review examined patients with squamous and basal cell carcinomas referred over a 5-year period to two senior authors.
Results:
In total, 233 patients had a total of 312 lesions excised. Thirty-nine (12.5%) of these lesions (in 33 patients) demonstrated no residual tumor on pathologic examination. Twelve patients were managed nonoperatively (5.15%) and observed to have had no tumor recurrence with a mean observation period of 14.66 months (range 1-54 months). Thus, approximately 19.3% of all patients referred had no residual tumor.
Conclusion:
Based on our observations and low proclivity for metastases, nonoperative monitoring of NMSC may be a reasonable option for certain lesions less than 1 cm that are undiscernible at the time of referral.
