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Table 1: Summary of main characteristics of reviewed studies
Authors Study Demographic data Tumor Location tumor Tumor stage and
(year) design (No. of subjects; gender; type and No. of patients No. of patients
age range; mean age)
El-Fole et Prospective 61 patients; Oral SCC Tongue: 20; T1: 4;
[23]
al. (2014) 39 M (63.9%), mucosa alveolar margin mandible: 13; T2: 47;
22 F (36.1%); buccal mucosa: 15; retromolar trigone: 6; T3: 5;
35-69 years; floor of the mouth: 3; T4: 5
mean 51.6 years mucosa alveolar margin maxilla: 4
Egemen et NR 21 patients; Lip SCC Lower lip: 15; T1: 8;
al. (2014) 14 M (66.6%), 7 F (33.3%); Upper lip: 5; T2: 10
[24]
47-92 years; mean 71.1 years Commisure: 1 T3: 3
Cheng et NR 41 patients; Oral SCC Group 1: buccal mucosa, mandibular T1: 11; T2: 16;
[20]
al. (2008) 21 M (51%), 20 F (49%); Alveolar ridge and retromolar trigone - 21; T3: 1; T4: 11;
35-95 years; Group 2: maxilar alveolar ridge and hard 2 patients
mean 67 years palate - 6; Group 3: oral tongue - 14 excluded
[16]
Mistry et al. Retrospective 27 patients; Oral SCC Oral tongue - 16; T1: 11; T2: 11;
(2005) 18 M (66.6%), 9 F (33.3%); buccal mucosa - 11 T3: 3; T4: 2
36-61 years; mean 47.6 years
M: male; F: female; NR: not reported; SCC: squamous cell carcinoma
Table 2: Summary of the measurements made in the analyzed studies
Authors Margin identification; Surgical Mearuing time, Mean Shrinkage by site Shrinkage
(year) surgical instrument; measurement pre-post resection shrinkage by stage
resection margin;
measuring instrument
El-Fole et al. Margin ink/sutures; In situ/pre- NR 47.6% buccal mucosa; 66.7% buccal NR
[23]
(2014) electocautery; resection; 33.3% tongue; mucosa;
1 cm; inmediately 9.5% mandibular 35% tongue;
metric ruler or caliper post-resection alveolus; 33.3% floor of mouth;
4.8% floor of mouty; 15.4% mandibular
4.8% retromolar alveolus;
trigon 16.7% retromolar trigon
Egemen et Margin ink; In situ/pre- At 24 h and 48 h 41-47%; NR NR
[24]
al. (2014) not indicated; resection; of fixation (volume, volume decrease
1 cm; inmediately tumor length and 21.8%
metric ruler/water post-resection distance); After 48 h of
flooding fixation - standardized
fashion
[20]
Cheng et al. Margin ink; In situ/pre- NR 59.02% 71.90% Group 1; T1/T -51.48%;
(2008) not indicated; 1 cm; resection 53.33% Group 2; T3/T -75%
metric ruler 41.14% Group 3
[16]
Mistry et al. Margin ink/sutures; In situ/pre- Half on hour 22.7 % 23.5% tongue; T1-T2-25.6%;
(2005) electrocautery1 cm; resection post-resection 21.2% buccal T3-T4-9.2%
caliper mucosa
NR: not reported

all examined articles and only 2 of them reported the use measured at the time of the surgery and margins measured
of sutures as an additional means of margins identification. after histopathologic processing was observed in all studies
Only 2 studies indicated the instrument utilized for analyzed. Thus, Mistry et al. [16] reported a mean shrinkage
resection (electrocautery). The extent of the tumor was, in from the pre-resection to the post-resection measurement of
[20]
all cases, determined by visual inspection and palpation. 3.18 mm (22.7%) (P < 0.011). In their study, Cheng et al.
With regards to the measuring instruments used to assess informed a mean discrepancy between the in situ margins and
the discrepancy between “in situ” margins and “histologic” the histopathologic margins for all patients of 59.02% (P <
margin, 3 studies reported the use of the metric ruler as 0.001). However, El-Fol et al. described a mean discrepancy
[23]
measuring instrument, 1 study described the caliper as between intraoperative margins and histopathologic margins
the instrument utilized in the measurements and 1 study exclusively analyzing all close and positive margins. In this
informed the use of both instruments for measuring of the study, the mean discrepancy for buccal mucosa was 47.6%,
margins. All articles reported a measurement of surgical 33.3% for the tongue, 9.5% for the mandibular alveolus, and
margin prior to the surgical resection, but only 2 of them 4.8% for both, retromolar trigon and floor of the mouth. Finally,
[24]
indicated the time until the measurement recorded by the the study of Egemen et al. based on the surgical margins of
pathologist (one study at 24-48 h postresection and another the resected lip specimens, reported a mean decrease of up
study at half an hour after resection). to 41-47.5% in the length and of 21.8% in volume between
measurements performed before the resection and those
A statically significant discrepancy between margins obtained in the histopatologic study.
Plast Aesthet Res || Volume 3 || May 25, 2016 153