Feasibility study of ultrasound-guided resection of tongue cancer with immediate specimen examination to improve margin control – Comparison with conventional treatment
de Koning, Klijs J.; Koppes, Sjors A.; de Bree, Remco; Dankbaar, Jan Willem; Willems, Stefan M.; van Es, Robert J.J.; Noorlag, Rob
(2021) Oral Oncology, volume 116, pp. 1 - 7
(Article)
Abstract
OBJECTIVES: Squamous cell carcinoma of the tongue (SCCT) is preferably treated by surgery. Free resection margins (≥5 mm) provide local control and disease-free survival. However, close (1-5 mm) and positive margins (<1 mm) are frequently encountered. We present our first experience of in-vivo ultrasound (US) guided SCCT resections followed by
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ex-vivo US control on the resection specimen to obtain free margins. We compare the results with those from a hisorical cohort of 91 conventionally treated SCCT patients. MATERIALS AND METHODS: Ten patients with SCCT were included in a consecutive US-cohort. We aimed for a 5-10 mm margin during surgery, while we visualized the resection plane on US. Ex-vivo US measurements on the resection specimen determined whether there was any need for an immediate re-resection. US measurements were then compared with histopathology. Histopathological margins were compared with a consecutive cohort of 91 patients who had undergone conventional surgery for a SCCT. RESULTS: In the US cohort, 70% of the margins were free. In the conventional cohort, this figure was 17% (P = 0.005). US predicted minimal histopathological margin distance with a mean ± SD error of 1.9 ± 1.8 mm. The mean ± SD of the histopathological overall submucosal/deep margin distance was 7.9 ± 2.1 mm in the US cohort and 7.0 ± 2.2 mm in the conventional cohort (P = 0.188). Ex-vivo examination through use of US indicated an immediate re-resection, which prevented local adjuvant treatment. CONCLUSION: Use of US-guided SCCT resection is feasible and improves margin control.
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Keywords: Clinical study, Image-guided surgery, Oral cancer, Resection margin, Retrospective study, Squamous-cell carcinoma, Tongue cancer, Ultrasound, Carcinoma, Squamous Cell/diagnostic imaging, Tongue Neoplasms/diagnostic imaging, Humans, Margins of Excision, Ultrasonography, Interventional, Feasibility Studies, Ultrasonography, Oral Surgery, Oncology, Cancer Research, Journal Article, Research Support, Non-U.S. Gov't
ISSN: 1368-8375
Publisher: Elsevier Limited
Note: Funding Information: The work was supported by the Dutch Cancer Society (grant number 11906). Publisher Copyright: © 2021 The Authors Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.
(Peer reviewed)