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      Surgical margins in head and neck squamous cell carcinoma: A narrative review

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          Abstract

          Head and neck squamous cell carcinoma (HNSCC), a prevalent and frequently recurring malignancy, often necessitates surgical intervention. The surgical margin (SM) plays a pivotal role in determining the postoperative treatment strategy and prognostic evaluation of HNSCC. Nonetheless, the process of clinical appraisal and assessment of the SMs remains a complex and indeterminate endeavor, thereby leading to potential difficulties for surgeons in defining the extent of resection. In this regard, we undertake a comprehensive review of the suggested surgical distance in varying circumstances, diverse methods of margin evaluation, and the delicate balance that must be maintained between tissue resection and preservation in head and neck surgical procedures. This review is intended to provide surgeons with pragmatic guidance in selecting the most suitable resection techniques, and in improving patients’ quality of life by achieving optimal functional and aesthetic restoration.

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          Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries

          Ahmedin Jemal, Lindsey A Torre, Rebecca Siegel … (2018)
          This article provides a status report on the global burden of cancer worldwide using the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, with a focus on geographic variability across 20 world regions. There will be an estimated 18.1 million new cancer cases (17.0 million excluding nonmelanoma skin cancer) and 9.6 million cancer deaths (9.5 million excluding nonmelanoma skin cancer) in 2018. In both sexes combined, lung cancer is the most commonly diagnosed cancer (11.6% of the total cases) and the leading cause of cancer death (18.4% of the total cancer deaths), closely followed by female breast cancer (11.6%), prostate cancer (7.1%), and colorectal cancer (6.1%) for incidence and colorectal cancer (9.2%), stomach cancer (8.2%), and liver cancer (8.2%) for mortality. Lung cancer is the most frequent cancer and the leading cause of cancer death among males, followed by prostate and colorectal cancer (for incidence) and liver and stomach cancer (for mortality). Among females, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death, followed by colorectal and lung cancer (for incidence), and vice versa (for mortality); cervical cancer ranks fourth for both incidence and mortality. The most frequently diagnosed cancer and the leading cause of cancer death, however, substantially vary across countries and within each country depending on the degree of economic development and associated social and life style factors. It is noteworthy that high-quality cancer registry data, the basis for planning and implementing evidence-based cancer control programs, are not available in most low- and middle-income countries. The Global Initiative for Cancer Registry Development is an international partnership that supports better estimation, as well as the collection and use of local data, to prioritize and evaluate national cancer control efforts. CA: A Cancer Journal for Clinicians 2018;0:1-31. © 2018 American Cancer Society.
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            Nasopharyngeal carcinoma

            Yu-Pei Chen, Anthony Chan, Quynh-Thu Le … (2019)
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              Head and neck squamous cell carcinoma

              Daniel E. Johnson, Barbara Burtness, C. René Leemans … (2020)
              Most head and neck cancers are derived from the mucosal epithelium in the oral cavity, pharynx and larynx and are known collectively as head and neck squamous cell carcinoma (HNSCC). Oral cavity and larynx cancers are generally associated with tobacco consumption, alcohol abuse or both, whereas pharynx cancers are increasingly attributed to infection with human papillomavirus (HPV), primarily HPV-16. Thus, HNSCC can be separated into HPV-negative or HPV-positive HNSCC. Despite evidence of histological progression from cellular atypia through various degrees of dysplasia, ultimately leading to invasive HNSCC, most patients are diagnosed with late-stage HNSCC without a clinically evident antecedent premalignant lesion. Traditional staging of HNSCC using the tumour-node-metastasis system has been supplemented by the 2017 AJCC/UICC staging system, which incorporated additional information relevant to HPV-positive disease. The treatment approach is generally multimodal, consisting of surgery followed by chemotherapy plus radiation (chemoradiation or CRT) for oral cavity cancers and primary CRT for pharynx and larynx cancers. The EGFR monoclonal antibody cetuximab is generally used in combination with radiation in HPV-negative HNSCC where co-morbidities prevent the use of cytotoxic chemotherapy. The FDA approved the immune checkpoint inhibitors pembrolizumab and nivolumab for treatment of recurrent or metastatic HNSCC and pembrolizumab as primary treatment for unresectable disease. Elucidation of the molecular genetic landscape of HNSCC over the past decade has revealed new opportunities for therapeutic intervention. Ongoing efforts aim to integrate our understanding of HNSCC biology and immunobiology to identify predictive biomarkers that will enable delivery of the most effective, least toxic therapies.
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                Author and article information

                Contributors
                Yang Chen
                Nian-Nian Zhong
                Lei-Ming Cao
                Bing Liu
                Lin-Lin Bu
                Journal
                Journal ID (nlm-ta): Int J Surg
                Journal ID (iso-abbrev): Int J Surg
                Journal ID (publisher-id): JS9
                Title: International Journal of Surgery (London, England)
                Publisher: Lippincott Williams & Wilkins (Hagerstown, MD )
                ISSN (Print): 1743-9191
                ISSN (Electronic): 1743-9159
                Publication date Collection: June 2024
                Publication date (Electronic): 11 March 2024
                Volume: 110
                Issue: 6
                Pages: 3680-3700
                Affiliations
                [a ]State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology
                [b ]Department of Oral & Maxillofacial – Head Neck Oncology, School & Hospital of Stomatology, Wuhan University, Wuhan, People’s Republic of China
                Author notes
                [* ]Corresponding authors. Address: School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China. Tel.: +876 862 15. E-mail: liubing9909@ 123456whu.edu.cn (B. Liu); Tel.: +876 862 15. E-mail: lin-lin.bu@ 123456whu.edu.cn (L.-L. Bu).
                Article
                Publisher ID: IJS-D-23-03071 Accession ID: 00054
                DOI: 10.1097/JS9.0000000000001306
                PMC ID: 11175762
                SO-VID: a589585d-43a0-4c75-8620-e000215bb2b5
                Copyright © Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
                License:

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/

                History
                Date received : 27 December 2023
                Date accepted : 26 February 2024
                Categories
                Subject: Reviews
                Custom metadata
                OPEN-ACCESS TRUE

                ScienceOpen disciplines: Surgery
                Keywords: assessment method,head and neck squamous cell carcinoma,neoadjuvant therapy,surgery,surgical margin
                Data availability:
                ScienceOpen disciplines: Surgery
                Keywords: assessment method, head and neck squamous cell carcinoma, neoadjuvant therapy, surgery, surgical margin

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