Intraoperative Margin Assessment Methods in Oral Cavity Squamous Cell Carcinoma: A Systematic Review and...

Area of Science:

• Oncology
• Surgical Pathology
• Head and Neck Surgery

Background:

• Intraoperative margin analysis is critical for oral cavity squamous cell carcinoma (OCSCC) treatment.
• Consensus on the superiority of specimen-based versus tumor bed-based margin analysis in OCSCC is lacking.

Purpose of the Study:

• To conduct the first meta-analysis comparing specimen-based and tumor bed-based intraoperative margin assessment in OCSCC.
• To determine if different margin analysis methods significantly impact patient outcomes.

Main Methods:

• A comprehensive literature search was conducted across PubMed, Embase, and Web of Science.
• Included studies performed both specimen-driven and tumor bed-driven margin analysis in OCSCC patients.
• Random effects meta-analyses were employed to synthesize data from 9 eligible studies (1240 participants).

Main Results:

• Specimen-based analysis showed higher re-resection rates and significantly lower final positive margin rates (P<.05).
• A decreased local recurrence rate was observed with specimen-based analysis compared to tumor bed-based (P<.05).
• No significant differences were found in overall recurrence or survival outcomes between the two methods.

Conclusions:

• Specimen-based frozen margin analysis in OCSCC leads to lower false negative rates and enhanced local control.
• Despite improved local control, specimen-based versus tumor bed-based methods do not significantly alter overall recurrence or survival.
• Further research may be needed to fully elucidate long-term outcome differences.