caa a22 4500 606182861 CHVBK 20210128100818.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s00405-015-3547-3 doi (NATIONALLICENCE)springer-10.1007/s00405-015-3547-3 Management of surgical margins after endoscopic laser surgery for early glottic cancers: a multicentric evaluation in French-speaking European countries [Elektronische Daten] [Nicolas Fakhry, Sébastien Vergez, Emmanuel Babin, Karine Baumstarck, Laure Santini, Patrick Dessi, Antoine Giovanni] The aim of this study was to evaluate the practices of ENT surgeons for the management of surgical margins after endoscopic laser surgery for early glottic cancers. A questionnaire was sent to different surgeons managing cancers of the larynx in France, Belgium and Switzerland. A descriptive and comparative analysis of practices across centers was performed. Sixty-nine surgeons completed the questionnaire (58 in France, 10 in Belgium and 1 in Switzerland). In case of very close or equivocal resection margins after definitive histological examination, 67% of surgeons perform close follow-up, 28% further treatment and 5% had no opinion. Factors resulting in a significant change in the management of equivocal or very close margins were: the country of origin (p=0.011), the specialty of the multidisciplinary team leader (p=0.001), the fact that radiation equipment is located in the same center (p=0.027) and the access to IMRT technique (p=0.027). In case of positive resection margins, 80% of surgeons perform further treatment, 15% surveillance, and 5% had no opinion. The only factor resulting in a significant change in the management of positive margins was the number of cancers of the larynx treated per year (p=0.011). It is important to spare, on one hand equivocal or very close margins and on the other hand, positive margins. Postoperative management should be discussed depending on intraoperative findings, patient, practices of multidisciplinary team, and surgeon experience. This management remains non-consensual and writing a good practice guideline could be useful. Springer-Verlag Berlin Heidelberg, 2015 Cancer nationallicence Larynx nationallicence Head and neck nationallicence Endoscopic surgery nationallicence Radiotherapy nationallicence Fakhry Nicolas Service d'ORL et Chirurgie Cervico-Faciale, Assistance Publique-Hôpitaux de Marseille (AP-HM), Aix-Marseille Université, Centre Hospitalier Universitaire (CHU) la Timone, 264 rue Saint Pierre, 13385, Marseille Cedex 05, France aut Vergez Sébastien Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire Rangueil-Larrey, 24 chemin de Pouvourville, 31059, Toulouse Cedex 09, France aut Babin Emmanuel Service d'ORL et Chirurgie Cervico-Faciale, CHU Côte de Nacre, avenue de la Côte de Nacre, 14033, Caen Cedex 9, France aut Baumstarck Karine Unité d'Aide Méthodologique à la Recherche Clinique, Assistance Publique-Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, 264 rue Saint Pierre, 13385, Marseille Cedex 05, France aut Santini Laure Service d'ORL et Chirurgie Cervico-Faciale, Assistance Publique-Hôpitaux de Marseille (AP-HM), Aix-Marseille Université, Centre Hospitalier Universitaire (CHU) la Timone, 264 rue Saint Pierre, 13385, Marseille Cedex 05, France aut Dessi Patrick Service d'ORL et Chirurgie Cervico-Faciale, Assistance Publique-Hôpitaux de Marseille (AP-HM), Aix-Marseille Université, Centre Hospitalier Universitaire (CHU) la Timone, 264 rue Saint Pierre, 13385, Marseille Cedex 05, France aut Giovanni Antoine Service d'ORL et Chirurgie Cervico-Faciale, Assistance Publique-Hôpitaux de Marseille (AP-HM), Aix-Marseille Université, Centre Hospitalier Universitaire (CHU) la Timone, 264 rue Saint Pierre, 13385, Marseille Cedex 05, France aut European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/6(2015-06-01), 1465-1469 0937-4477 272:6<1465 2015 272 405 https://doi.org/10.1007/s00405-015-3547-3 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00405-015-3547-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Fakhry Nicolas Service d'ORL et Chirurgie Cervico-Faciale, Assistance Publique-Hôpitaux de Marseille (AP-HM), Aix-Marseille Université, Centre Hospitalier Universitaire (CHU) la Timone, 264 rue Saint Pierre, 13385, Marseille Cedex 05, France aut NATIONALLICENCE 700 1- Vergez Sébastien Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire Rangueil-Larrey, 24 chemin de Pouvourville, 31059, Toulouse Cedex 09, France aut NATIONALLICENCE 700 1- Babin Emmanuel Service d'ORL et Chirurgie Cervico-Faciale, CHU Côte de Nacre, avenue de la Côte de Nacre, 14033, Caen Cedex 9, France aut NATIONALLICENCE 700 1- Baumstarck Karine Unité d'Aide Méthodologique à la Recherche Clinique, Assistance Publique-Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, 264 rue Saint Pierre, 13385, Marseille Cedex 05, France aut NATIONALLICENCE 700 1- Santini Laure Service d'ORL et Chirurgie Cervico-Faciale, Assistance Publique-Hôpitaux de Marseille (AP-HM), Aix-Marseille Université, Centre Hospitalier Universitaire (CHU) la Timone, 264 rue Saint Pierre, 13385, Marseille Cedex 05, France aut NATIONALLICENCE 700 1- Dessi Patrick Service d'ORL et Chirurgie Cervico-Faciale, Assistance Publique-Hôpitaux de Marseille (AP-HM), Aix-Marseille Université, Centre Hospitalier Universitaire (CHU) la Timone, 264 rue Saint Pierre, 13385, Marseille Cedex 05, France aut NATIONALLICENCE 700 1- Giovanni Antoine Service d'ORL et Chirurgie Cervico-Faciale, Assistance Publique-Hôpitaux de Marseille (AP-HM), Aix-Marseille Université, Centre Hospitalier Universitaire (CHU) la Timone, 264 rue Saint Pierre, 13385, Marseille Cedex 05, France aut NATIONALLICENCE 773 0- European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/6(2015-06-01), 1465-1469 0937-4477 272:6<1465 2015 272 405