Pitfalls in determining head and neck surgical margins

Oral Maxillofac Surg Clin North Am. 2014 May;26(2):151-62. doi: 10.1016/j.coms.2014.01.003.


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.

Keywords: Autofluorescent; Cancer; Frozen; Hypermethylation; Margin; Oral cavity; Resection; Shrinkage.

Publication types

  • Review

MeSH terms

  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Neoplasm Invasiveness / pathology
  • Neoplasm Recurrence, Local / prevention & control
  • Neoplasm, Residual / pathology
  • Neoplasm, Residual / surgery
  • Risk Assessment
  • Survival Analysis
  • Tumor Burden