The application of molecular biology techniques in the evaluation of surgical margins is an appealing concept, intuitively logical, technically feasible, and already tested in pilot studies. Effective surgical treatment dictates that the cancer be removed in its entirety. If even a tiny amount of tumor is left in place, it is likely to grow and again pose a threat to the health and life of the patient within a short period of time. Molecular assessment of surgical margins provides improved prediction of local-regional tumor recurrence and patient survival. Molecular assessment of margins has not yet been validated in a large, multi-institutional trial confirming the clinical accuracy of the information and the potential for widespread application of the techniques. The selection of a therapeutic response to a positive molecular or traditional margin depends on pragmatic and technical factors, on one's assessment of the biological phenomenon that led to the positive margin, and on the tools available for further therapy. Removing an area of minimal residual tumor is an obvious response to positive tumor margins. If a positive margin reflects only the failure of a surgeon to remove enough tissue, then further resection alone might render the patient free of risk for recurrence.
ASJC Scopus subject areas
- Biochemistry, Genetics and Molecular Biology(all)