Margins of Excision

The edges of tissue removed in a surgery for assessment of the effectiveness of a surgical procedure in achieving the local control of a neoplasm and the adequacy of tumor removal. When the margin is negative or not involved by tumor (e.g., CANCER) it suggests all of the tumor has been removed by the surgery.

Also Known As:

Negative Surgical Margins; Positive Surgical Margins; Resection Margin; Surgical Margins; Tumor-Free Margins; Excision Margin; Excision Margins; Margin, Resection; Margin, Surgical; Margin, Tumor-Free; Margins, Resection; Margins, Surgical; Margins, Tumor-Free; Negative Surgical Margin; Positive Surgical Margin; Resection Margins; Surgical Margin; Surgical Margin, Negative; Surgical Margin, Positive; Surgical Margins, Negative; Surgical Margins, Positive; Tumor Free Margins; Tumor-Free Margin

Networked: 8365 relevant articles (355 outcomes, 658 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Neoplasms (Cancer)
2.	Neoplasm Metastasis (Metastasis)
3.	Carcinoma (Carcinomatosis)
4.	Prostatic Neoplasms (Prostate Cancer)
5.	Rectal Neoplasms (Rectal Cancer)

Experts

1.	Graefen, Markus: 46 articles (01/2022 - 04/2003)
2.	Karakiewicz, Pierre I: 38 articles (10/2020 - 12/2005)
3.	Montorsi, Francesco: 34 articles (01/2022 - 07/2004)
4.	Scardino, Peter T: 31 articles (01/2022 - 02/2002)
5.	Huland, Hartwig: 30 articles (01/2022 - 04/2003)
6.	Shariat, Shahrokh F: 29 articles (12/2021 - 03/2004)
7.	Eastham, James A: 28 articles (01/2022 - 12/2003)
8.	Briganti, Alberto: 27 articles (01/2021 - 12/2006)
9.	Freedland, Stephen J: 26 articles (10/2020 - 02/2002)
10.	Tilki, Derya: 23 articles (01/2022 - 08/2008)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Margins of Excision:

1.	Hormones (Hormone)IBA 06/01/2008 - "A PSA at diagnosis<10 ng/ml, positive surgical margins, absence of seminal vesicle involvement and neoadjuvant hormones were all associated with a trend towards improved BPFS. " 06/01/2021 - "The multivariate analysis showed a significant association between the N-Tmab and Tmab group (hazard ratio, 3.03; 95% confidence interval, 1.07-8.59) and IBTR in addition to close or positive resection margin and hormone receptor (HR) positivity. " 11/29/2018 - "A Cox regression model was used to calculate hazard ratios of death, taking into account the age and menopause status, molecular subtype, stage of disease, histological grade, lymphatic and vascular invasion, resection margin, hormone receptor expression, and treatment modality. " 10/01/2011 - "Potential prognostic factors associated with a poorer overall survival include a positive liver surgical margin and hormone refractory disease. " 06/01/2009 - "Univariate analyses demonstrated that administration of RT, the resection margin status, hormone responsiveness, T stage, N stage and stage were significantly related to IBTR. "
2.	Prostate-Specific Antigen (Semenogelase)IBA 01/01/2008 - "The aim of this study was to examine the impact of surgical margin status on serum prostate-specific antigen (sPSA) relapse in men consecutively receiving RP in a non-screened population. " 11/01/1999 - "Both conferences concluded that the following factors are recommended for routine use based on evidence from multiple published trials: TNM stage, histological grade using the Gleason system, surgical margin status, and serum prostate-specific antigen concentration. " 08/01/2023 - "Multivariate analysis identified initial prostate-specific antigen level and positive surgical margins (PSM) as significant predictors of BCR in PCa patients with pT3b undergoing RARP. " 01/31/2023 - "However, the continence rate at 3 months after RARP, positive surgical margins, and prostate-specific antigen (PSA)-relapse-free survival showed no significant differences between the two groups. " 01/01/2022 - "Age, Gleason, Charlson score, positive surgical margins, pathological stage, and positive nodes number, but not prostate specific antigen, were most relevant prognostic factors. "
3.	AndrogensIBA 05/29/2007 - "Trials investigating other anti-androgens in the past also reported lower frequencies of surgical margin positivity, but patients outcome has not improved. " 11/15/2008 - "A total of 78 patients with pT3 or positive surgical margins after RP were treated with RT plus 2 years of androgen suppression, according to a Phase II study. " 01/01/2006 - "PSApt, pathological grade, surgical margin status, age, clinical stage and immediate androgen ablation were evaluated in a multivariate analysis regarding bRFS. " 11/01/1998 - "Within these constraints neoadjuvant androgen ablation was significantly associated with low pT stage and negative surgical margin. " 03/01/1998 - "Surgical margins were positive in 80% of the men in the androgen deprivation failure group and in 21% in the neoadjuvant hormonal therapy group (p = 0.001). "
4.	ParaffinIBA 03/01/2007 - "Using the microendoscope we report our experience in the determination of surgical margins at operation and later comparison with frozen section and paraffin section margins "gold standard". " 05/01/2008 - "The surgical margin status was evaluated by both frozen and permanent paraffin section studies. " 01/01/2023 - "RCM was performed at the clinically defined initial surgical margin followed by margin-controlled staged excision with paraffin-embedded tissue, and histopathology was correlated with RCM results. " 01/01/2021 - "Archival paraffin blocks of 243 cases of NSCLC and 104 non-cancerous tissue samples from the surgical margin (control) were obtained from patients treated at the Clinic of Thoracic Surgery of Wroclaw Medical University (Wroclaw, Poland) between 2010 and 2016, and were used for tissue microarrays and immunohistochemical (IHC) experiments. " 11/01/2016 - "Thirty-four patients with SGC who had undergone excision with 5-mm surgical margins and paraffin section pathologic analysis. "
5.	Biomarkers (Surrogate Marker)IBA 09/01/2007 - "We believe that molecular studies are necessary to identify biomarkers and to determine genetic alterations in histopathologically normal surgical margins." 01/01/2023 - "We found a significant association between these biomarkers and pT stage (PD-L1, p = 0.020; CD3+TILs, p = 0.025), tumour grade (PD-L1, p = 0.005; CD3+TILs, p = 0.004), positive surgical margin (PD-L1, p = 0.001; CD3+TILs, p = 0.001), MSI (PD-L1, p < 0.001; CD3+TILs, p < 0.001), etc. We also discovered that these biomarkers are independent risk factors for MSI (PD-L1, OR = 1.84 [1.27-4.02], p = 0.003; CD3+TILs, OR = 1.92 [1.31-4.35], p = 0.008). " 12/01/2022 - "The surgical margins are a surrogate marker for later recurrences or long-term survival and this is what guides our treatment but equally attempts should be made to preserve their function and not increase the morbidity." 01/01/2022 - "In particular, Axin2 and Snail are potential predictive biomarkers for the risk assessment of surgical margins in OSCC." 01/01/2021 - "Circumferential resection margin involvement has remained an independent, poor prognostic factor for local recurrence and survival in most recent literature, indicating that circumferential resection margin status can still be used as a short-term surrogate endpoint."
6.	Carcinoembryonic AntigenIBA 08/27/2023 - "A hybrid predicting model was created through multivariable logistic regression analysis, integrating the radiomics score with significant clinical risk factors (baseline Carcinoembryonic Antigen (CEA), clinical circumferential resection margin status, and the short axis diameter of LPLN). " 01/01/2023 - "Radiomic Nomo charts were developed using Rad scores obtained from the integrated image omics model, circumferential resection margin(CRM), DoTD, and carcinoembryonic antigen(CEA). " 01/01/2022 - "Risk factors for decreased overall survival included age >75 (hazard ratio 3.3, P < .001), male sex (hazard ratio 1.2, P < .001), White/Black race (hazard ratio 1.4, P = .020), preoperative carcinoembryonic antigen >3.5 ng/mL (hazard ratio 1.6, P < .001), T4a T-stage (hazard ratio 2.0, P < .001), T4b T-stage (hazard ratio 2.4, P < .001), lymphovascular invasion (hazard ratio 1.2, P = .003), perineural invasion (hazard ratio 1.3, P = .003), and non-R0 proximal/distal resection margins (hazard ratio 1.7, P < .001). " 11/01/2020 - "Risk factors including elevated preoperative carcinoembryonic antigen (CEA), higher ypTNM stage, positive circumferential resection margin (CRM), and perineural invasion were significantly associated with ER. " 10/02/2020 - "Additionally, univariate analysis identified the MRI circumferential resection margin (mrCRM) and pre-treatment carcinoembryonic antigen (CEA) as significant predictor of RFS (HR 2.082, 95% CI 1.106-3.919; p = 0.023 and HR 1.005, 95% CI 1.002-1.008; p < 0.001). "
7.	Imatinib Mesylate (Gleevec)FDA Link 02/01/2013 - "Preoperative imatinib was associated with improved surgical margins. " 01/01/2018 - "Curative treatment requires surgery, which may be preceded by neoadjuvant imatinib if it is felt that this will aid in achieving clear (R0) resection margins. " 01/15/2014 - "Patients with advanced primary or locally recurrent DFSP and measurable disease by RECIST (response evaluation criteria in solid tumors) were eligible and received imatinib 600 mg/d until definitive surgery with histopathologic proof of tumor-free margins. " 01/14/2005 - "A negative surgical margin and the use of STI-571 after surgical resection were good prognostic indicators. " 11/27/2023 - "Central gastrectomy and gastro-gastric anastomosis were performed with negative resection margins, and the patient received post-operative imatinib, achieving disease control throughout an 8-month post-operative follow-up. "
8.	TitaniumIBA 10/01/2014 - "In order to obtain disease-free surgical margins, 1/3 distal part of the sternum with costochondral junctions was resected and reconstruction of anterior chest wall was performed with titanium mesh. " 06/01/2018 - "The distance between the cutting edge and the titanium fasteners was 3.10 mm with NALS, which was sufficient to resect the true resection margin tissue for pathology evaluation. " 11/01/2017 - "It was treated by wide margin resection with fibular grafting, titanium elastic nail system along with cancellous bone graft reconstruction." 07/01/2015 - "The tumour resection margins were labelled with an average of 18 titanium clips. " 12/01/2011 - "After ensuring surgical margins were cleared of tumor infiltration, orbital reconstruction was performed with titanium plate and nasolabial flap. "
9.	Formaldehyde (Formol)FDA Link 04/01/2019 - "'En bloc' OSCC resection and histopathologic evaluation of margins on the formalin-fixed specimen remain the 'gold standard' for oral oncologic surgery, whereas assessment of intraoperative surgical margins and its overall clinical value are still questioned and debated in the literature. " 06/01/2017 - "The purpose of this study was to show the effect of formalin fixation on surgical margins. " 01/01/2014 - "This study aims to evaluate the alterations in distances to the surgical margins on sheep tongue specimens, through resection, formalin fixation, frozen section, and microscopic examination. " 01/01/2008 - "Our study demonstrates that naked eye assessment of surgical margins after formalin fixation is inaccurate and that surgical margins are often inadequate. " 07/01/1997 - "It was the purpose of this study to quantify the change in size of mucosal and muscle surgical margins following excision, formalin fixation, and slide preparation of tongue and labiobuccal tissue in a canine model. "
10.	Capsules (Microcapsules)IBA 05/01/2018 - "According to the pathomorphological study, the prostatic capsule was intact, and surgical margins were negative in all cases. " 10/01/2022 - "The surgical margin was negative without capsule damage. " 07/08/2022 - "Pathological information of the biopsy and radical resection specimens was used to analyze the correlation between pathological parameters in the biopsy report and adverse pathological features of radical resection specimens, including increased Gleason score, capsule invasion, positive surgical margin and perineural invasion. " 05/01/2022 - "In PA, younger age, major pseudo-capsule defects, and surgical margins were the most relevant factors affecting local control. " 05/25/2021 - "Central to the IASLC definition of complete resection is an adequate nodal evaluation either by systematic nodal dissection or lobe-specific systematic nodal dissection, as well as the integrity of the highest mediastinal node, the nodal capsule and the resection margins. "

Therapies and Procedures

1.	Radiotherapy 01/01/2021 - "In addition, postoperative radiotherapy (PORT) has been proven to be effective in local control of ACC of the head and neck (ACCHN) with a high rate of nerve invasion and close surgical margin. " 04/25/1999 - "Quantitative evaluation of surgical margin status, apart fromwhether or not radiotherapy was performed, is important for estimating the riskand disease-free period to in-breast recurrence." 02/01/2022 - "These tumours represent a multitude of situations and histologies, where surgery is the mainstay of treatment and radiotherapy is frequently needed for malignant tumours (in case of stage T3-T4, nodal involvement, extraparotid invasion, positive or close resection margins, histological high-grade tumour, lymphovascular or perineural invasion, bone involvement postoperatively, or unresectable tumours). " 08/01/2019 - "Postoperative radiotherapy seems to be beneficial in patients with positive surgical margins." 01/01/2018 - "While post-operative radiotherapy was not associated with improved survival for patients without high-risk adverse features (high grade or positive surgical margins), its use was associated with better survival for ECE-positive salivary SCC patients without one of these additional adverse features (HR 0.064; p = 0.010). "
2.	Therapeutics 12/01/2023 - "Performance status, negative surgical margins, and adjuvant therapy were clinically significant and univariable with improved OS (p < 0.05), regardless of ethnicity. " 12/01/2019 - "His good outcome provides evidence that stopping antifungal therapy after achieving clear surgical margins is acceptable in patients without ongoing immunosuppression." 03/01/2015 - "Complications, positive surgical margin rates and the requirement for adjuvant therapy are all improved with the robotic approach but did not show statistically significant differences." 11/01/2009 - "To determine the difference in size between computed tomography (CT)-based irradiated boost volumes and simulator-based irradiated volumes in patients treated with breast-conserving therapy and to analyze whether the use of anisotropic three-dimensional clinical target volume (CTV) margins using the histologically determined free resection margins allows for a significant reduction of the CT-based boost volumes. " 12/01/2006 - "The newly devised reconstruction methods with VABS can markedly increase the mammary gland resection volume while achieving a good esthetic outcome, ensuring a precise disease-free surgical margin, and expanding the indications for breast-conserving therapy."
3.	Drug Therapy (Chemotherapy) 01/01/2006 - "Future studies should attempt to develop an optimal chemotherapy regimen, set an appropriate resection margin, and find an effective treatment for patients with extensively calcified lesions." 05/01/1995 - "The treatment protocol of these patients was as follows: stage I patients (T1-T2) with normal surgical resection margins underwent no adjuvant treatment (10 patients); stage I patients (T1-T2) with resection margins infiltrated by the disease were submitted to local irradiation; stage I (T3-T4) and stage II E1 patients underwent large-field postoperative irradiation (14 patients); stage II E2 patients (n = 19) received conventional chemotherapy (CHOP, F-CVP, N-CVP): the ones who failed to reach complete remission or presented with bulky disease at diagnosis completed the treatment with large-field irradiation (10 patients). " 02/15/2002 - "Reresection of a positive resection margin does not necessarily have to be performed, because postoperative chemotherapy showed good results. " 01/01/2022 - "Conclusions: Our results suggest that LRT is associated with improved OS in women with dnMBC, and patients who had surgery after systemic chemotherapy with negative surgical margins, are expected to benefit more." 04/25/2005 - "Subgroup analyses estimated that chemoradiation was more effective and chemotherapy less effective in patients with positive resection margins. "
4.	Prostatectomy (Retropubic Prostatectomy) 03/01/2011 - "• Intraoperative achievement of a locally disease-free status, as monitored by negative circumferential intraoperative FS of peripheral margins, is not associated with a statistically significant BCR-free survival benefit compared with patients with negative surgical margins on the prostatectomy specimen. " 06/01/2007 - "A significantly greater incidence (P = 0.035) of benign glands at the surgical margins was found within the robotic group compared with the open retropubic prostatectomy group (54% versus 15%). " 06/01/2014 - "Thompson, Sam Egger, Maret Böhm, et al. Superior quality of life and improved surgical margins are achievable with robotic radical prostatectomy after a long learning curve: a prospective single-surgeon study of 1552 consecutive cases. " 06/01/2014 - "Thompson, Sam Egger, Maret Böhm, et al. Superior quality of life and improved surgical margins are achievable with robotic radical prostatectomy after a long learning curve: a prospective single-surgeon study of 1552 consecutive cases. " 03/01/2014 - "Superior quality of life and improved surgical margins are achievable with robotic radical prostatectomy after a long learning curve: a prospective single-surgeon study of 1552 consecutive cases."
5.	Adjuvant Chemotherapy 09/07/2022 - "Adjuvant chemotherapy after resective surgery was most effective in patients with metastatic lesions located just outside the surgical margin; in addition, these metastatic lesions were the most sensitive to adjuvant chemotherapy. " 01/01/2021 - "MIS was associated with improved postoperative mortality (3.4 vs. 7.2%, p > .001), surgical margins, optimal lymph node harvest, adjuvant chemotherapy use and 5-year survival (46% vs. 41%, P < .001). " 12/30/2016 - "Hence, an early diagnosis, prompt surgical resection with negative resection margin along with adjuvant chemotherapy can provide complete remission. " 01/01/2023 - "We found a significant improvement in overall survival in patients with a negative resection margin (p= 0.037) and in patients who received adjuvant chemotherapy (p= 0.039). " 06/01/1997 - "With margins of less than 5 mm, 27% of patients were alive and disease-free as compared to 62% with surgical margins greater than 5 mm. The importance of early diagnosis, definitive surgical treatment and aggressive adjuvant chemotherapy is demonstrated. "