The role of separate margins sampling in endoscopic laser surgery for early glottic cancer.

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The role of separate margins sampling in endoscopic laser surgery for early glottic cancer.

Acta Otolaryngol. 2016;136(5):491-6

Authors: Shoffel-Havakuk H, Lahav Y, Davidi ES, Haimovich Y, Hain M, Halperin D

Abstract
CONCLUSIONS: Sampling surgical margins in trans-oral laser microsurgery for early glottic squamous cell carcinoma (SCC) may allow for increased local control rate, although with no difference in local control by endoscopic treatment alone.
OBJECTIVE: To further delineate the role of routinely sampling separate surgical margins, in patients with early glottic SCC undergoing endoscopic laser resection.
METHODS: A retrospective case control study. One hundres and two early glottic cancer patients staged Tis-T2 underwent endoscopic laser surgery with curative intent as the primary treatment. Separate margins from the surgical bed were sampled following complete tumor resection in 64 patients; in 38 patients no margins were sampled.
RESULTS: Margin sampling showed a tendency towards reduced risk for local recurrence, adjusted HR = 0.439 (p-value = 0.096). However, there was no difference in local control by endoscopic treatment alone. The patients with sampled margins were further divided based on margins' status: 39 (61%) had negative margins, and 25 (39%) had positive margins. Compared with negative margins, patients with positive margins showed increased risk for recurrence, adjusted HR = 8.492 (p = 0.008). When margins were not sampled the risk for local recurrence was increased compared to negative margins (adjusted HR = 7.875, p-value = 0.008), and relatively comparable to what was observed when sampled margins were positive (adjusted HR = 0.927, p-value = 0.88).

PMID: 26817681 [PubMed - indexed for MEDLINE]

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