title: The role of separate margins sampling in endoscopic laser surgery for early glottic cancer.
abstract: CONCLUSIONS
  Sampling surgical margins in trans-oral laser microsurgery for early glottic squamous cell carcinoma (SCC) may allow for increased local control rate, although with no difference in local control by endoscopic treatment alone.
  
  
  OBJECTIVE
  To further delineate the role of routinely sampling separate surgical margins, in patients with early glottic SCC undergoing endoscopic laser resection.
  
  
  METHODS
  A retrospective case control study. One hundres and two early glottic cancer patients staged Tis-T2 underwent endoscopic laser surgery with curative intent as the primary treatment. Separate margins from the surgical bed were sampled following complete tumor resection in 64 patients; in 38 patients no margins were sampled.
  
  
  RESULTS
  Margin sampling showed a tendency towards reduced risk for local recurrence, adjusted HR = 0.439 (p-value = 0.096). However, there was no difference in local control by endoscopic treatment alone. The patients with sampled margins were further divided based on margins' status: 39 (61%) had negative margins, and 25 (39%) had positive margins. Compared with negative margins, patients with positive margins showed increased risk for recurrence, adjusted HR = 8.492 (p = 0.008). When margins were not sampled the risk for local recurrence was increased compared to negative margins (adjusted HR = 7.875, p-value = 0.008), and relatively comparable to what was observed when sampled margins were positive (adjusted HR = 0.927, p-value = 0.88).
authors.affiliation: a The Department of Otolaryngology Head and Neck Surgery , Kaplan Medical Center , Rehovot , Israel ;|b The Hebrew University, Hadassah Medical School , Jerusalem , Israel.
authors.forename: Hagit
authors.initials: H
authors.lastname: Shoffel-Havakuk
authors.affiliation: a The Department of Otolaryngology Head and Neck Surgery , Kaplan Medical Center , Rehovot , Israel ;|b The Hebrew University, Hadassah Medical School , Jerusalem , Israel.
authors.forename: Yonatan
authors.initials: Y
authors.lastname: Lahav
authors.affiliation: a The Department of Otolaryngology Head and Neck Surgery , Kaplan Medical Center , Rehovot , Israel ;
authors.forename: Erez Shmuel
authors.initials: ES
authors.lastname: Davidi
authors.affiliation: a The Department of Otolaryngology Head and Neck Surgery , Kaplan Medical Center , Rehovot , Israel ;
authors.forename: Yaara
authors.initials: Y
authors.lastname: Haimovich
authors.affiliation: a The Department of Otolaryngology Head and Neck Surgery , Kaplan Medical Center , Rehovot , Israel ;
authors.forename: Moshe
authors.initials: M
authors.lastname: Hain
authors.affiliation: a The Department of Otolaryngology Head and Neck Surgery , Kaplan Medical Center , Rehovot , Israel ;|b The Hebrew University, Hadassah Medical School , Jerusalem , Israel.
authors.forename: Doron
authors.initials: D
authors.lastname: Halperin
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D005931:Glottis / Q000473:pathology*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007828:Laryngoscopy / Q000379:methods*; D053685:Laser Therapy; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D012189:Retrospective Studies
keywords: Cancer; endoscopic laser resection; glottic carcinoma; glottis; local control; margins status