How do you manage a head and neck cancer patient with the presence of high grade dysplasia at a margin?

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...

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 concern we occasional...