Excisional biopsy with margin control for oral cancers

Background This study was undertaken to show how an excisional biopsy procedure can be used to remove the entire specimen for oral lesions with difficult diagnoses. Methods We retrospectively reviewed 52 cases with 56 oral lesions either suspected to be malignant or with a preliminary controversial diagnosis. These were treated by excisional biopsy with frozen section intraoperatively between January 2003 and June 2008. Results Twenty-eight of 56 lesions were diagnosed with malignancy. We found a high underdiagnosis rate (7 of 12) in patients who had a preliminary controversial diagnosis. Twenty-one patients without preoperative biopsy were diagnosed to have malignancies. Of the 28 malignant cases, all surgical margins were negative. Neck ultrasound scans with fine-needle aspiration cytology was carried out and no patient demonstrated simultaneous neck metastasis. One patient died of locoregional recurrence. Two patients died of a second primary cancer. Conclusion Excisional biopsy with margin control is useful both in diagnosis and treatment of oral cancers.