Assessment of Surgical Margins
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In oral cavity SCCs, tumor margin status is an important prognostic factor. Achieving negative margins depends primarily on the surgeon skills and the accuracy of intraoperative margin assessment. Tumor margin of less than 5 mm is considered as close margin, while ≥5 mm is defined as negative margin. In patients with early-stage SCC of the oral cavity, close margins were associated with over twofold increase in the risk of recurrence, compared with negative margins. Patients with positive/close margins are amenable to adjuvant radiation or chemoradiation therapy. The utility of specimen-driven margin analysis is associated with a higher rate of negative margins than the traditional patient-driven margin analysis. Specimen-driven margin analysis can prevent escalation of adjuvant treatment in up to 30% of the patients.
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