An attempt to reduce close and positive margins in oral cancer using Lugol‘s Iodine

Nithyla Thamburatnam; Rajinikanth J; Amit J Tirkey; John C. Muthusami

Volume : V, Issue : XI, November - 2016

An attempt to reduce close and positive margins in oral cancer using Lugol‘s Iodine

Nithyla Thamburatnam, Rajinikanth J, Amit J Tirkey, John C. Muthusami

Abstract :

Introduction: Conventionally, all operable oral cancers are excised with 1–1.5 cms margins. The presence of invasive tumour or dysplasia within 5 mm of the surgical margins can leads to local recurrence. The use of Lugol�s iodine, a vital stain, has shown promising results to improve intraoperative identification of the extent of the tumour and dysplasia at the margins to reduce recurrence. Materials and methods: Consecutive patients with resectable primary tumours of the oral cavity were enrolled in the Lugol�s iodine study, between 01.01.12 and 31.10.13 (group II). The extent of the tumour on clinical examination was marked. The margins of the malignancy prior to, and following the application of Lugols iodine were compared. The institutional records of all patients who underwent curative resection of squamous cell carcinoma of the oral cavity from 01.03.10 – 31.12.11 (group I) were reviewed. The incidence of close and positive margins was studied, retrospectively in group I and prospectively in group II, and compared. Results: Overall, tongue cancers were the most common and approximately 80% percent of patients were within the 40 –60 years age group. The incidence of close margins (invasive carcinoma < 4cm from the margin) had decreased from 39% in group I to 32% in group II. The incidence of involved margins (invasive carcinoma at the margin) had decreased from 25% in the group I to 8% in group II (p=0.000). Conclusion: The use of Lugol�s iodine helped us define the tumour circumference better, thereby improving the incidence of tumour free surgical margins.