학술논문
How far are we off? Analyzing the accuracy of surgical margin relocation in the head and neck.
Document Type
Academic Journal
Author
Miller A; Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Wang V; Division of Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA.; Jegede V; Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA.; Necker F; Institute of Functional and Clinical Anatomy, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.; Curry J; Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.; Baik FM; Department of Otolaryngology - Head and Neck Surgery, Stanford University, Palo Alto, California, USA.; Verma A; Division of Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA.; Holsinger FC; Department of Otolaryngology - Head and Neck Surgery, Stanford University, Palo Alto, California, USA.; Tuluc M; Department of Pathology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.; Rahman M; Department of Pathology, Stanford University, Palo Alto, California, USA.; Lewis JS Jr; Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Rosenthal E; Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Topf MC; Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Source
Publisher: John Wiley And Sons Country of Publication: United States NLM ID: 8902541 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-0347 (Electronic) Linking ISSN: 10433074 NLM ISO Abbreviation: Head Neck Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Positive surgical margin rates remain high in head and neck cancer surgery. Relocation is challenging given the complex, three-dimensional (3D) anatomy.
Methods: Prospective, multi-institutional study to determine accuracy of head and neck surgeons and pathologists relocating margins on virtual 3D specimen models using written descriptions from pathology reports. Using 3D models of 10 head and neck surgical specimens, each participant relocated 20 mucosal margins (10 perpendicular, 10 shave).
Results: A total of 32 participants, 23 surgeons and 9 pathologists, marked 640 margins. Of the 320 marked perpendicular margins, 49.7% were greater than 1 centimeter from the true margin with a mean relocation error of 10.2 mm. Marked shave margins overlapped with the true margin a mean 54% of the time, with no overlap in 44 of 320 (13.8%) shave margins.
Conclusions: Surgical margin relocation is imprecise and challenging even for experienced surgeons and pathologists. New communication technologies are needed.
(© 2024 The Authors. Head & Neck published by Wiley Periodicals LLC.)
Methods: Prospective, multi-institutional study to determine accuracy of head and neck surgeons and pathologists relocating margins on virtual 3D specimen models using written descriptions from pathology reports. Using 3D models of 10 head and neck surgical specimens, each participant relocated 20 mucosal margins (10 perpendicular, 10 shave).
Results: A total of 32 participants, 23 surgeons and 9 pathologists, marked 640 margins. Of the 320 marked perpendicular margins, 49.7% were greater than 1 centimeter from the true margin with a mean relocation error of 10.2 mm. Marked shave margins overlapped with the true margin a mean 54% of the time, with no overlap in 44 of 320 (13.8%) shave margins.
Conclusions: Surgical margin relocation is imprecise and challenging even for experienced surgeons and pathologists. New communication technologies are needed.
(© 2024 The Authors. Head & Neck published by Wiley Periodicals LLC.)