Intraoperative Margin Assessment Methods in Oral Cavity Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

Tuesday, October 14, 2025

8:24 AM - 8:30 AM EDT

Location: 128

Disclosure(s):

David SJ Millay, MD, OD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Michael I. Orestes, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Currently, there is a lack of consensus regarding the superiority of specimen-based vs tumor-bed based margin analysis in oral cavity squamous cell carcinoma (OCSCC). The purpose of this study is to perform the first meta-analysis examining intraoperative margin assessment methods in OCSCC with the goal of determining if there is a significant difference in patient outcomes between specimen-driven and tumor bed-driven margin analysis.

Methods: A comprehensive search of the literature was performed using PubMed, Embase, Web of Science, and Ovid All EBM Reviews. Studies met inclusion criteria if they conducted intraoperative specimen-driven and tumor bed-driven margin analysis in patients with OCSCC and reported outcomes to include final positive margin rate, false negative rate, recurrence, and/or survival. Random effects meta-analyses were used to analyze the compiled data. The authors strictly adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) strategy.

Results: The literature search returned 2518 articles for initial review of which 10 (1737 participants) met criteria for inclusion and meta-analysis. Meta-analysis revealed final positive margin rate to be significantly lower in specimen-based margin analysis (p < 0.05); however, there was no significant difference (p >0.05) in recurrence or survival outcomes when comparing specimen-based vs tumor bed-based margin analysis.

Conclusions: Specimen-based and tumor bed-based margin analysis in OCSCC result in similar patient outcomes with no significant difference in recurrence or survival. However, specimen-based analysis had lower positive margin rates thus reducing the need for re-resections.

Presenting Author(s)

JC

John J. Caraway, MD

Otolaryngology Resident
Walter Reed National Military Medical Center
Bethesda, MD, United States

Disclosure information not submitted.
DM

David SJ Millay, MD, OD

Otolaryngology Resident
Walter Reed National Military Medical Center
Gaithersburg, MD, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

DM

David SJ Millay, MD, OD

Otolaryngology Resident
Walter Reed National Military Medical Center
Gaithersburg, MD, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
HK

Ha Eun Kim, BS

Medical Student
Uniformed Services University of the Health Sciences, United States

Disclosure information not submitted.
AY

Alex Yang, MD

Walter Reed National Military Medical Center, United States

Disclosure information not submitted.
NW

Nora Watson, PhD

Biostatistician
Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, MD, United States

Disclosure information not submitted.
RA

Rhonda Allard, MLIS

Uniformed Services University, United States

Disclosure information not submitted.

Senior Author(s)

MO

Michael I. Orestes, MD

Associate Professor Surgery
United States Army, Otolaryngology-Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, MD
Bethesda, Maryland, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.