دورية أكاديمية
أعرض في EDS

Frequency and accuracy of intraoperative bone margin sampling for T4a cancers of the head and neck at the QEII Health Sciences Centre: a retrospective chart review.

التفاصيل البيبلوغرافية
العنوان: Frequency and accuracy of intraoperative bone margin sampling for T4a cancers of the head and neck at the QEII Health Sciences Centre: a retrospective chart review.
المؤلفون: Lamport AC; Faculty of Medicine, Dalhousie University, Halifax, NS, Canada., MacKay CA; Division of Otolaryngology-Head and Neck Surgery, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada., Bullock MJ; Department of Pathology, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada., Taylor SM; Division of Otolaryngology-Head and Neck Surgery, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada., Trites JR; Division of Otolaryngology-Head and Neck Surgery, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada., Corsten M; Division of Otolaryngology-Head and Neck Surgery, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada., Rigby MH; Division of Otolaryngology-Head and Neck Surgery, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada. mhrigby@dal.ca.
المصدر: Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale [J Otolaryngol Head Neck Surg] 2023 Jan 31; Vol. 52 (1), pp. 6. Date of Electronic Publication: 2023 Jan 31.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101479544 Publication Model: Electronic Cited Medium: Internet ISSN: 1916-0216 (Electronic) Linking ISSN: 19160208 NLM ISO Abbreviation: J Otolaryngol Head Neck Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: 2013- : London : BioMed Central
Original Publication: Hamilton, Ont. : Decker
مواضيع طبية MeSH: Head* , Neoplasms*, Humans ; Retrospective Studies ; Neck ; Chemoradiotherapy, Adjuvant
مستخلص: Background: Stage T4a cancers are associated with a 5-year survival of 21.6-59.0%. Adequate resection of these tumors is a critical factor in maximizing survival. Tumors invading bone pose a unique challenge to intraoperative bone margin assessment. Due to processing limitations, there had been no formal standardized protocol for intraoperative bone sampling at the QEII Health Sciences Centre. These resections often involve extensive reconstruction, making salvage surgery difficult if positive margins are detected post-surgically. The purpose of this study was to assess the accuracy and frequency of intraoperative bone margin assessment during the study period and to determine survival and recurrence rates associated with positive final bone margins.
Methods: A retrospective chart review was conducted including patients with stage T4a head and neck cancer involving bone that underwent primary surgical resection in Nova Scotia between 2009 and 2019. Eligible patients were identified through the Cancer Care Nova Scotia registry. Exclusion criteria included patients with stage T4a tumors involving bone that did not receive primary surgical treatment with curative intent and patients with stage T4a tumors that did not invade bone.
Results: Of 67 patients included, 50 were amenable to intraoperative bone margin sampling while 18 had intraoperative sampling. Four patients had positive intraoperative margins and one had final positive bone margins. The incidence of final bone margin positivity was 7.5%. Median survival following surgery was 4.56 years for patients with final negative bone margins (n = 62) and 3.98 years for patients with positive final bone margins (n = 5). All patients with final positive bone margins received adjuvant radiation therapy. Of patients with negative final bone margins, 16.1% received no adjuvant therapy, 61.3% received adjuvant radiation therapy and 21.0% received adjuvant chemoradiation therapy.
Conclusion: Intraoperative bone margin sampling occurred in 26.8% of all cases and 36.0% of amenable cases. Median survival of patients with positive final bone margins was 0.58 years lower than those with negative final bone margins, although this difference did not reach statistical significance. This will provide baseline data for comparison of the standardized intraoperative bone margin sampling protocol implemented at the QEII Health Sciences Centre.
(© 2023. The Author(s).)
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معلومات مُعتمدة: PSO-EST-2019-2188 Research Nova Scotia Establishment Grant
فهرسة مساهمة: Keywords: Bone margins; Intraoperative margin sampling; Stage T4a
تواريخ الأحداث: Date Created: 20230201 Date Completed: 20230202 Latest Revision: 20230203
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC9890935
DOI: 10.1186/s40463-022-00609-2
PMID: 36721208
قاعدة البيانات: MEDLINE
الوصف
تدمد:1916-0216
DOI:10.1186/s40463-022-00609-2