Nithyla Rosalynn, J (2014) The use of Lugol's iodine in achieving surgical margins free from dysplasia and invasive carcinoma in squamous cell carcinoma of the oral cavity. Masters thesis, Christian Medical College, Vellore.
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Abstract
INTRODUCTION: Head and neck malignancies are the sixth most common of all malignancies worldwide, squamous cell carcinoma accounting for 95% of them. In the Indian subcontinent however, it is overall, the most common cancer. In terms of frequency, it ranks first among the male population and third among the female population. The reason for this increased incidence can be attributed to the habit of chewing paan, khaini and other forms of smokeless tobacco, peculiar to this geographical location, which in addition to alcohol and smoking, has been identified as one of the major risk factors in the development of oral malignancies. AIM OF THE STUDY: To study the utility of Lugol’s iodine in achieving tumour free surgical margins in squamous cell carcinoma of the oral cavity. OBJECTIVES: 1. To determine whether the use of Lugol’s iodine resulted in reduced incidence of involved and close surgical margins, in squamous cell carcinoma of the oral cavity. 2. To determine whether the use of Lugol’s iodine enabled the surgeon to visualize the tumour extent better compared to clinical examination alone. 3. To study the staining patterns observed following local application of Lugol’s iodine in squamous cell carcinoma of the oral cavity. 4. To look for association between the various staining patterns and the incidence of involved and close resection margins on final histopathology. MATERIALS AND METHODS: We evaluated the use of Lugol’s iodine in achieving surgical margins free of dysplasia or invasive carcinoma by an observational study of two sets of patients who underwent resection for oral carcinoma between 15.05.10 – 15.06.11 and from 15.09.12 to 15.10.13. The patients in the second group underwent staining with 1.25% Lugol’s iodine as per the described procedure. The patterns of staining were noted and the margins on clinical examination and following Lugol’s staining were compared. Resection was left to the surgeon’s discretion. Margin status was compared with the retrospective cohort of 60 patients operated over a similar duration. RESULTS: 90 patients underwent resection in the study period between 15.09.12 to 15.10.13, of which data from 30 patients was available for analysis. The incidence of close and positive margins decreased significantly (17% vs 37% and 6% vs 38% respectively) in the cohort where Lugol’s iodine was used (p = 0.000). CONCLUSION: With appropriate patient selection, staining with Lugol’s iodine appears to be a promising method of obtaining tumour free resection margins in carcinoma of the oral cavity. However, studies with a larger sample size and randomization are required to further establish it’s utility.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Lugol's iodine ; surgical margins free ; dysplasia ; invasive carcinoma ; squamous cell carcinoma ; oral cavity. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Devi S |
| Date Deposited: | 07 Jul 2018 02:30 |
| Last Modified: | 07 Jul 2018 02:30 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/8691 |
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