A New Proposal for Adequate Resection Margins in Larynx and Hypopharynx Tumor Surgery—: Are the RCP Guidelines Feasible?

Simone E. Bernard*, Cornelia G.F. van Lanschot, Jose A. Hardillo, Dominiek A. Monserez, Cees A. Meeuwis, Robert J. Baatenburg de Jong, Senada Koljenović, Aniel Sewnaik

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background:
Resection margins are an important prognostic factor for patients with head and neck cancer. In general, for head and neck surgery, a margin >5 mm is advised by the Royal College of Pathologists. However, this cannot always be achieved during laryngeal and hypopharyngeal surgery. The aim of this study is to identify the resection surfaces and measure the maximum feasible margins per subsite. The clinical relevance of these maximum feasible resection margins were analyzed in this descriptive anatomical study.

Methods:
head and neck surgeons and a pathologist from the Erasmus MC performed a total laryngectomy and laryngopharyngectomy on a head and neck specimen specifically available for research.

Results:
For a total laryngectomy, resection margins >5 mm were not feasible for the ventral and dorsal resection surface. For a total laryngopharyngectomy, resection margins >5 mm were not feasible for the ventral, dorsal and lateral resection surface.

Conclusion:
Clear resection margins, defined as a margin >5 mm, are not always feasible in laryngeal and hypopharyngeal surgery, due to the anatomy of the larynx and tumor location. However, striving for a maximum feasible margin is still the main goal. We propose a new guideline for maximum feasible but adequate resection margins in larynx and hypopharynx tumor surgery.

Original languageEnglish
Article number2058
Number of pages9
JournalCancers
Volume16
Issue number11
Early online date29 May 2024
DOIs
Publication statusPublished - Jun 2024

Bibliographical note

Publisher Copyright:
© 2024 by the authors.

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