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Topic: State of the Art in the Management of Oral Squamous Cell Carcinoma

The tissue shrinkage phenomenon

on surgical margins in oral and

oropharyngeal squamous cell carcinoma

David González-Ballester
Department of Oral and Maxillofacial-Head and Neck Surgery, University Hospital Infanta Cristina, 06080 Badajoz, Spain.
Address for correspondence: Dr. David González-Ballester, Department of Oral and Maxillofacial, University Hospital Infanta Cristina,
Avda. Elvas s/n, 06080 Badajoz, Spain. E-mail: dgonzalezballester@gmail.com

Dr. David González-Ballester, M.D., Ph.D., obtained his Medical Degree at University of Extremadura
School of Medicine in Badajoz, Spain, in 2003. He completed his training as a specialist in Family
and Community Medicine in 2007 and subsequently in Oral and Maxillofacial Surgery in 2013 at
the University Hospital Infanta Cristina, Badajoz, Spain. He received his Doctoral Degree at the
University of Extremadura School of Medicine, Badajoz, Spain in 2014. He is currently working as a
consultant surgeon at the Department of Oral and Maxillofacial Surgery in University Hospital Infanta
Cristina, Badajoz, Spain, and he participates as University Honorary Collaborator at the University of
Extremadura School of Medicine, Badajoz, Spain.

ABSTRACT
Aim: One of the most important factors associated with recurrence rate and overall survival
is the status of surgical margin of resection free of disease. However, sometimes, the margins
measured intra-operatively at the time of surgery differ of those measured by the pathologist in
the histopathologic analysis. Faced with this dilemma, a literature review of the best available
evidence was conducted in an attempt to determine how the phenomenon of tissue shrinkage
may influence on the surgical margin of resection in patients undergoing oral and oropharyngeal
squamous cell carcinoma (SCC). Methods: An electronic and manual search was conducted by
one reviewer. A combination of controlled Medical Subjects Headings and keywords were used
as search strategy. Inclusion and exclusion criteria were established. Results: Finally, after an
exhaustive selection process, four articles fulfilled the inclusion criteria and were analyzed. All
articles reported a decrease of surgical margin after resection. The tumor site and tumor stage
seem to influence in degree of margin shrinkage. Conclusion: Tissue shrinkage on surgical
margins of resection in oral SCC is a tangible phenomenon. There is a significant discrepancy
between margins measured intraoperatively previous to resection and margins measured by
pathologist after histologic processing. The highest percentage of retraction occurs at the time of
resection. Margin shrinkage based on tumor site and tumor stage should be considered by any
oncologic surgeon to ensure adequate margins of resection cleared of tumor.

Key words:
Squamous cell carcinoma; tissue shrinkage; surgical margin; retraction; oral cavity; oropharynx

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How to cite this article: González-Ballester D. The tissue shrinkage
phenomenon on surgical margins in oral and oropharyngeal
DOI: squamous cell carcinoma. Plast Aesthet Res 2016;3:150-7.
10.20517/2347-9264.2016.23
Received: 08-04-2016; Accepted: 03-05-2016
150 © 2016 Plastic and Aesthetic Research | Published by OAE Publishing Inc.