Deep margin assessment by intraoperative ultrasound in tongue cancer- dust trial

Introduction: Oral cancer ranks sixth among all cancers globally and India has the most significant number of cases, one-third of the total burden of oral cancer cases globally. The aim of the study was to conduct deep margin assessment using intraoperative ultrasound in superficial oral tongue carcinomas, ensuring adequate surgical resection for early-stage oral tongue cancer minimizing loco regional recurrence risks. Methodology: This is a prospective observational study involving 91 diagnosed tongue malignancies. The study included biopsy verified tongue cancer. During the surgical procedure and effect of general anaesthesia the tongue lesions of the patient were evaluated with intraoral sonography. An intraoral transducer probe characterized by an 8 to 10 MHz ultrasonic beam Siemens Acuson NX3 was used to assess the deep margin, tumor thickness, margins, and other findings like lingual nodes are noted. Results: A total of 91 patients that underwent resection using intraoperative USG were included in the study. The majority of the patients were in the age group 41 - 60 years. As carcinoma tongue is more common in males our study has a sex distribution of 63 male and 28 females. The mean deep margin assessed by USG - is 0.901cm and the mean deep margin assessed by the frozen section is 0.762 cm. The mean deep margin assessed by final histology is 0.748 cm. Conclusion: USG guided resection of early tongue cancers is a technique that is able to increase the frequency of free margins and decrease the close margin and positive margin frequency when compared to conventional treatment. USG being noninvasive is a very fast method in comparison to the frozen section and seems to be a promising technique. Larger studies are needed with control groups to possibly confirm a statistically significant difference in adequate deep resection margin and improvement in DSS and quality of life in future. Keywords: deep margin; tongue; carcinoma