Margin Practices in Oral Cavity Cancer Resections: Survey of American Head and Neck Society Members

Mustafa G. Bulbul, Joseph Zenga, Osama Tarabichi, Anuraag S. Parikh, Rosh K. Sethi, K. Thomas Robbins, Sidharth V. Puram, Mark A. Varvares

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Objectives/Hypothesis: To investigate the definition of a clear margin and the use of frozen section (FS) among practicing head and neck surgeons in oral cancer management. Study Design: Cross-sectional survey. Methods: We designed a survey that was sent to American Head and Neck Society (AHNS) members via an email link. Results: A total of 185 (13% of 1,392) AHNS members completed our survey. Most surgeons surveyed (96.8%) use FS to supplement oral cavity squamous cell carcinoma resections. Fifty-five percent prefer a specimen-based approach. The majority of respondents believe FS is efficacious in guiding re-resection of positive margins, with 81% considering the new margin to be negative. More than half of respondents defined a distance of >5 mm on microscopic examination as a negative margin. Conclusions: To avoid oral cancer resections that result in positive margins on final analysis, and thus the need for additional therapy, most surgeons surveyed use FS. A majority of surveyed surgeons now prefer a specimen-based approach to margin assessment. Although there is a debate on what constitutes a negative margin, most surgeons surveyed believe it to be >5 mm on microscopic examination. Level of Evidence: 4 Laryngoscope, 131:782–787, 2021.

Original languageEnglish
Pages (from-to)782-787
Number of pages6
Issue number4
StatePublished - Apr 2021


  • Frozen section
  • margin
  • oral cavity cancer
  • oral cavity squamous cell carcinoma
  • resection
  • survey


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