Surgical margins in head and neck cancer

The histopathologic status of excision margins of squamous cell carcinomas of the head and neck has long been used as a potential indicator for recurrences and prognosis. The predictive ability of the margin, however, is far from satisfactory. The relatively high incidence of- recurrence in patients with histopathologic tumor-free resection margins strongly suggests that small foci of (pre)neoplastic cells have remained undetectable. Another reason for tumor recurrence may be that a 'field' of preneoplastic cells has remained in the patient after resection of the primary tumor. Novel sensitive molecular techniques in detection of (prc)neoplastic lesions in surgical margins are currently being investigated. Their predictive value, however, remains to be proven unequivocally. Also less laborious methods are warranted before such methods can be implemented into routine practice.