title: Pitfalls in determining head and neck surgical margins.
abstract: Accurate assessment of surgical margins in the head and neck is a challenge. Multiple factors may lead to inaccurate margin assessment such as tissue shrinkage, nonstandardized nomenclature, anatomic constraints, and complex three dimensional specimen orientation. Excision method and standard histologic processing techniques may obscure distance measurements from the tumor front to the normal tissue edge. Arbitrary definitions of what constitutes a "close" margin do not consider the prognostic significance of resection dimensions. In this article we review some common pitfalls in determining margin status in head and neck resection specimens as well as highlight newer techniques of molecular margin assessment.
authors.affiliation: Department of Otorhinolaryngology, University of Texas Health Science Center at Houston, 6431 Fannin Street MSB 5.031, Houston TX 77030, USA. Electronic address: y.etan.weinstock@uth.tmc.edu.
authors.forename: Y Etan
authors.initials: YE
authors.lastname: Weinstock
authors.affiliation: Department of Otorhinolaryngology, University of Texas Health Science Center at Houston, 6431 Fannin Street MSB 5.031, Houston TX 77030, USA.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Alava
authors.affiliation: Head and Neck Surgical Associates and Oregon Health & Science University, 1849 Northwest Kearney, Suite 300, Portland, OR 97209, USA.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Dierks
mesh_terms: D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D018365:Neoplasm, Residual / Q000473:pathology / Q000601:surgery; D018570:Risk Assessment; D016019:Survival Analysis; D047368:Tumor Burden
keywords: Autofluorescent; Cancer; Frozen; Hypermethylation; Margin; Oral cavity; Resection; Shrinkage