The crucial balance in surgical margins for head and neck oncology. Introduction

Achieving clear surgical margins is essential in head and neck cancer surgery, directly influencing local control, survival, and quality of life. The challenge lies in balancing oncologic safety with functional preservation, particularly in speech and swallowing. Surgeons must remove tumours with sufficient margins while minimising unnecessary tissue loss. Historically, positive margins – tumour cells at or near the resection edge – significantly increase recurrence risk. Margin classifications as “positive”, “close,” or “clear” guide clinical decisions, but recent evidence underscores the need for site-specific definitions. A ≥ 5 mm margin is standard for oral cavity tumours, though narrower thresholds suffice for certain procedures, especially with intraoperative frozen section analysis (FSA) and advanced imaging technologies like narrow-band imaging and fluorescence-guided surgery.

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https://www.actaitalica.it/article/view/1255/708