title: Open questions and novel concepts in oral cancer surgery.
abstract: The persistence of cancerous cells after surgery in oral squamous cell carcinoma (OSCC) represents a major challenge, as it often leads to local recurrences and secondary primary tumors, which are eventually responsible for a large proportion of deaths. This persistence is currently evaluated by histological analyses. In this review we discuss some important pitfalls of the histopathological analysis, such as margin evaluation, specimen shrinkage and T staging. In addition, we critically analyze the appropriateness of current surgical techniques in relation to the concept of field cancerization. Finally, we describe some novel imaging and molecular approaches, which might be useful in tailoring surgical resections and encourage the use of OSCC animal models to explore and provide proof of concept of the feasibility and potential clinical utility of innovative surgical protocols.
authors.affiliation: Division of Otolaryngology and Head and Neck Surgery, Cattinara Hospital, University of Trieste, Trieste, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Tirelli
authors.affiliation: Molecular Medicine, International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Zacchigna
authors.affiliation: School of Dental Sciences, University of Trieste, Trieste, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Biasotto
authors.affiliation: Division of Otolaryngology and Head and Neck Surgery, Cattinara Hospital, University of Trieste, Trieste, Italy. marcopiovesana81@gmail.com.
authors.forename: Marco
authors.initials: M
authors.lastname: Piovesana
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D002985:Clinical Protocols; D006801:Humans; D000072662:Margins of Excision; D009062:Mouth Neoplasms / Q000473:pathology / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000517:prevention & control; D013048:Specimen Handling / Q000379:methods
keywords: Field cancerization; Histopathology; Local recurrences; Margin status; Optical imaging; Oral squamous cell carcinoma; Radiotherapy; Secondary primary tumors; Surgical approach