Margin Shrinkage in Oral Squamous Cell Carcinoma: A Prospective Observational Study

Oral squamous cell carcinoma (OSCC) is one the most encountered malignancies by the oncologists in the Indian subcontinent. Adequate margin is the most sought-after goal during resection of OSCC. Margin discrepancy in oral cavity squamous cell carcinoma is frequent cause of disagreement between surgeons and pathologists. To assess the amount of margin of shrinkage, we conducted a prospective observational study in a tertiary care hospital in western state of India over a period of 2 years. 2-reference points for margin were selected and distance between these two points was measured in-situ, after resection, after formalin fixation and after histopathological processing. 44 patients were enrolled in the study. Mean shrinkage of 33.41% was noted. Statistically significant shrinkage was noted in all steps viz. post resection (15.31%), after formalin fixation (7.31%) and after histopathological processing (10.79%). No variation in shrinkage was noted owing to patient or tumour related factors. Significant margin shrinkage occurs in all cases of oral cavity squamous cell carcinoma irrespective of patient or tumour related factors with maximum shrinkage occurring post resection. Pathological margins are 2/3rd of surgical margin and this discrepancy shall be kept in mind while attempting wide local resection.