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Head and Neck Cancers • Radiation Oncology
How do you manage a head and neck cancer patient with the presence of high grade dysplasia at a margin?
Do you consider this a positive margin? Would you boost this area to a higher dose? Would you recommend concurrent chemotherapy in the absence of other risk factors?
Answer from: Radiation Oncologist at Academic Institution
This is an excellent question. According to some pathological literature, a margin positive for in situ carcinoma or high grade dysplasia has a similar recurrence risk as a frankly positive margin with invasive disease. NCCN guidelines define carcinoma in situ or invasive disease as a "positive marg...
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Answer from: Radiation Oncologist at Academic Institution
Many pathologists consider high grade dysplasia equivalent to SCC in situ. If it is localized, re-resect if it makes sense clinically. Sometimes if dz is diffuse and there is wide field cancerization and no gross lesion we just watch. Sometimes if dz is not anatomic and we have concer...