Abstract
Background:Epithelial dysplasia (ED) at oral cancer excision margins is a frequent finding. Dysplastic epithelium at excision margins may not be similar to dysplasia in Oral potentially malignant disorders (OPMD) as malignant transformation has already taken place. Therefore, management of ED at excision margins should be different to that of OPMD. ED creates a dilemma in relation to further management of cancer patients, since there are no accepted guidelines. Therefore, the objective of this review is to analyze existing literature and to arrive at evidence based recommendations for the management of ED at excision margins. Methods:A comprehensive string was run on PubMed, Medscape and Medline. The final outcome included 113 studies. Finally, the most relevant 10 articles were critically assessed for inclusion and exclusion criteria against various parameters. Results and Conclusions: Severe and Moderate ED need re-excision in order to improve prognosis. There is not enough sound evidence for the management of Mild ED at excision margins of oral squamous cell carcinoma. Guidelines for the management of ED at excision margins should be formulated after comprehensive multi center studies using lager cohorts of patients.
Highlights
Oral squamous cell carcinoma (OSCC) is a common malignancy in some parts of the world which carries a high level of morbidity and mortality
Dysplastic epithelium at excision margins may not be similar to dysplasia in Oral potentially malignant disorders (OPMD) as malignant transformation has already taken place
The objective of this review is to evaluate all existing and available literature to analyze common practices and their outcomes when Epithelial dysplasia (ED) is diagnosed at surgical margins and to clarify the controversies in the subject
Summary
Oral squamous cell carcinoma (OSCC) is a common malignancy in some parts of the world which carries a high level of morbidity and mortality. Epithelial dysplasia (ED) is identified as an indicator of increased probability of occurrence of OSCC, in oral potentially malignant diseases (OPMD). Rate of transformation is stated as 10.3% (Mehanna et al, 2009) - 12 % (Raibel et al, 2017) within a mean duration of 4.3 years (Mehanna et al, 2009) It is a frequent finding the surgical excision margins of already evolved OSCC. There is not enough sound evidence for the management of Mild ED at excision margins of oral squamous cell carcinoma. Guidelines for the management of ED at excision margins should be formulated after comprehensive multi center studies using lager cohorts of patients
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