Clinicopathological analyses of fifty supracricoid laryngectomized specimens: evidence base supporting minimal margins.
OBJECTIVE
Supracricoid laryngectomy (SCL) is a reliable laryngeal preservation surgery. However, close surgical margins are often inevitable. Based on clinicopathological analyses of supracricoid laryngectomized specimens, we evaluated the evidence base supporting minimal margins.


METHODS
The distance between tumor edge and resected margin was measured macro- and microscopically at the anterior, posterior, superior and inferior edges, using 50 surgical specimens. The margins were correlated with pathological T staging and the prognoses.


RESULTS
The anterior and posterior margins were the shortest, and the superior margin was the longest. The inferior margin was the only edge at which a positive margin was encountered. Cancer extending 10 mm below the glottal free edge significantly decreased the inferior margin.


CONCLUSIONS
The surgical potential of SCL with cricohyoidoepiglottopexy was confirmed to be able to cope with tumor extensions showing margins of a few millimeters at the anterior, posterior and superior ends. Accurate assessment and management at the inferior margin is the key to stable local control.
Nakayama
Meijin
M
Department of Otorhinolaryngology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan. meijin@med.kitasato-u.ac.jp
Holsinger
Christopher
C
Okamoto
Makito
M
Seino
Yutomo
Y
Miyamoto
Shunsuke
S
Takeda
Masahiko
M
Yokobori
Satoru
S
Masaki
Takashi
T
Hayashi
Seiichi
S
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery*; D003413:Cricoid Cartilage / Q000473:pathology / Q000601:surgery; D004825:Epiglottis / Q000473:pathology / Q000601:surgery; D019317:Evidence-Based Medicine; D005260:Female; D005931:Glottis / Q000473:pathology / Q000601:surgery; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000517:prevention & control; D009367:Neoplasm Staging; D013957:Thyroid Cartilage / Q000473:pathology / Q000601:surgery