Molecular pathology may demonstrate @entity5 cells not detected by histology. The idea has emerged that these cells influence the prognosis negatively and that their detection will lead to more appropriate treatment and improved @entity1 survival. We theorized that @entity5 cells at surgical margins overlooked by the pathologist should demonstrate their clinical significance by causing recurrences at the primary site in the @entity1 reported to have @entity5 -free margins by histology. To assess this assumption, we investigated the prognostic influence of the histologically determined status of the surgical margins. The material that formed the basis of this study consisted of 394 @entity1 that underwent resection for their primary @entity5 during the years 1990-1995. In 207 @entity1 , initial treatment was complete as assessed by conventional histopathological examination of the surgical specimen. In 187 @entity1 , initial treatment was @entity5 in or close to the margin, or mild, moderate or severe @entity1141 or in situ @entity5 at the margin. Causes for treatment failure were recorded for both groups separately. In the group with @entity5 -free margins, 16.9% had a second primary @entity135 , 8.2% had a second @entity5 in the lung, 10.6% had recurrent disease in the neck, 2.9% had distant @entity3 , and 3.9% had local recurrence at the same site as the primary @entity5 . For the group without @entity5 -free margins, these figures were the following: second primary in the head and neck area: 17.1%, second primary in the lung: 7.0%, recurrent disease in the neck: 11.8%, distant @entity3 : 8.0% and local recurrence at the primary site: 21.9%. Local recurrences were rare in @entity1 in which the pathologist reported the resection to be complete. Although there may be @entity5 cells in surgical margins that evade histological detection, their clinical impact appears to be almost negligible.

Treatment failure and margin status in XXXX . A critical view on the potential value of molecular pathology.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity135 :: ('MESH:D006258', 'Disease') :: ['head and neck cancer'] @entity5 :: ('MESH:D009369', 'Disease') :: ['incomplete, defined as tumour', 'cancer', 'tumour'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis'] @entity1141 :: ('MESH:C535662', 'Disease') :: ['dysplasia']
@entity135 :: (MESH:D006258,Disease) :: ['head and neck cancer']
