Improving Oral Tongue Cancer Pathology Margins through Surgical Technique

Abstract

Objectives:

Compare pathology margins of oral tongue cancer patients undergoing partial glossectomy between a novel surgical technique and conventional surgical resection. Describe the horizontal mattress surgical technique for partial glossectomy.

Methods:

Patients with oral tongue cancer underwent partial glossectomy using a new surgical technique by the senior author from February 2011 to July 2013 at a tertiary care medical center. A retrospective comparison cohort was selected from prior patients of the department with age, sex, and tumor stage matching. Anterior, posterior, and medial pathology margins were compared between the groups. Mean values were compared with the Student t test for normally distributed variables, and median values were compared with the Wilcoxon-Mann-Whitney test for variables which were not normally distributed. The horizontal mattress technique for partial glossectomy is described.

Results:

Ten patients underwent partial glossectomy with the new technique. The mean medial pathology margin was significantly greater in the novel technique group (1.40 cm, 0.88 cm, P < .05; novel technique, conventional technique, P value). There were no significant differences in the median anterior margin (1.10 cm, 1.25 cm, P = .79), mean posterior margin (1.47 cm, 1.13 cm, P = .15), mean tumor size (1.91 cm, 1.71 cm, P = .67), or tumor depth of invasion (0.65 cm, 0.80 cm, P = .73).

Conclusions:

The new surgical technique using horizontal mattress sutures for dissection guidance and specimen orientation yielded significantly larger medial pathology margins compared to the traditional method. This study is limited by the retrospective nature of the comparison group. A prospective trial should be undertaken to confirm these results.