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How far are we off? Analyzing the accuracy of surgical margin relocation in the head and neck
Miller, Alexis Wang, Vickie Jegede, Victor Necker, Fabian Curry, Joseph Baik, Fred M. Verma, Avanti Holsinger, F. Christopher Tuluc, Madalina Rahman, Mobeen
Miller, Alexis
Wang, Vickie
Jegede, Victor
Necker, Fabian
Curry, Joseph
Baik, Fred M.
Verma, Avanti
Holsinger, F. Christopher
Tuluc, Madalina
Rahman, Mobeen
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Journal article
Date
2024-05-04
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DOI
https://doi.org/10.1002/hed.27793
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.
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Citation
Miller A, Wang V, Jegede V, et al. How far are we off? Analyzing the accuracy of surgical margin relocation in the head and neck. Head & Neck. 2024; 46(11): 2709-2716. doi:10.1002/hed.27793
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Wiley
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Head & Neck, Vol. 46, Iss. 11
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Attribution CC BY