Jafari A, et al. - In view of the literature's heterogeneity of the effect of positive surgical margins (PSM) on OS, researchers tested the assumption that extent of tumor extirpation (microscopic PSM vs macroscopic PSM) can play a role in OS. Seven thousand eight hundred eight patients with sinonasal squamous cell carcinoma (SNSCC; most common malignancy of the paranasal sinuses) were identified in the National Cancer Database. Of these, 4,543 patients had surgery, 3,265 patients had nonsurgical treatment. Investigators found that 1,033 of the surgery patients had PSM, and about half of these had macro-PSM. Findings revealed that the degree of extirpation of the tumor correlates with OS. Compared with nonsurgical treatment, macro-PSM did not confer an advantage on OS, and variables including tumor location and advanced nodal status influence whether surgery will lead to macro-PSM. Before choosing to proceed with SNSCC surgery, shared decision-making between patient and surgeon should take place on the basis of these findings.