Positive initial margins, even among
patients with negative final margins, appeared associated with poorer DFS among
patients with primary laryngeal squamous cell carcinoma who received total
laryngectomy, according to recently published findings. These were the findingof Tassone and colleagues of the Thomas Jefferson University.
The researchers performed a retrospective
cohort study of 237 patients who underwent total laryngectomy for squamous cell
carcinoma from February 2008 to July 2016. They considered margins positive if
they contained invasive carcinoma, carcinoma in situ or severe dysplasia.
A total of 225 patients had negative
final margins, and 127 underwent primary total laryngectomy, whereas 98
received salvage total laryngectomy. Salvage laryngectomy was associated with
significantly worse, whereas primary total laryngectomy was not.
The authors concluded that surgical
margin status may be an important prognostic factor in head and neck cancer. Furthermore,
positive initial frozen margins even in patients with negative final margins,
are associated with increased risk of local treatment failure in the context of
primary total laryngectomy.
Positive and negative tumor margins