Gross examination by the surgeon as an alternative to frozen section for assessment of adequacy of surgical margin in head and neck squamous cell carcinoma

Head and Neck - Tập 36 Số 4 - Trang 557-563 - 2014
Pankaj Chaturvedi1, Sourav Datta1, Sudhir Nair1, Deepa Nair1, Prashant Pawar1, Sagar Vaishampayan1, Asawari Patil2, Shubhada Kane2
1Department of Head and Neck Surgery, Tata Memorial Hospital, Mumbai, India
2Department of Pathology, Tata Memorial Hospital, Mumbai, India

Tóm tắt

BackgroundThe cost‐effectiveness of the frozen section for assessment of margin in head and neck squamous cell carcinoma (HNSCC) is still contentious. The purpose of this study was to evaluate whether gross examination of margin is an alternative to frozen section.MethodsIt was a prospective observational study in 145 consecutive patients undergoing surgery for HNSCC. Surgical margins were first assessed by the surgeons with a metallic scale. All specimens were then examined using frozen section and permanent section.ResultsOverall, 83% of inadequate margins were detected by frozen section. The chances of inadequate margin were very low if gross surgical margin were 7 mm or more. Gross examination alone (with 7 mm as cutoff) predicted 88% of the inadequate surgical margin. There was no difference in precision of frozen section vis‐à‐vis gross examination with 7 mm cut off (p ≤ .8).ConclusionAchievement of 7 mm surgical margin measured by a surgeon obviates the need for frozen section. © 2013 Wiley Periodicals, Inc. Head Neck 36: 557–563, 2014

Từ khóa


Tài liệu tham khảo

10.1002/hed.2890010203

10.1016/S0002-9610(05)80555-0

10.1016/0360-3016(87)90095-2

10.1054/ijom.2002.0313

10.1016/0964-1955(94)90044-2

10.1016/S0002-9610(00)00433-5

Jacobs JR, 1993, Implications of positive surgical margins, Laryngoscope, 103, 64, 10.1288/00005537-199301000-00012

10.1016/S1010-5182(05)80339-7

10.1002/(SICI)1097-0347(199908)21:5<408::AID-HED5>3.0.CO;2-E

10.1016/S1368-8375(01)00092-6

10.1056/NEJMoa032646

10.1056/NEJMoa032641

Woolgar JA, 1995, Survival, metastasis and recurrence of oral cancer in relation to pathological features, Ann R Coll Surg Engl, 77, 325

10.1016/j.ijom.2004.10.006

10.1016/j.joms.2005.07.011

10.1016/S0266-4356(03)00119-0

10.1038/bjc.1996.327

10.1001/archotol.1986.03780080063014

10.1016/S0278-2391(97)90570-X

Chaturvedi P, 2012, Utility of frozen section in assessment of margins and neck node metastases in patients undergoing surgery for the carcinoma of the tongue, J Cancer Res Ther, 8, S100, 10.4103/0973-1482.92222

10.1016/j.oraloncology.2006.10.001

10.1097/00005537-200010000-00039

10.1054/ijom.2002.0262

10.1002/hed.2880150108

Howanitz PJ, 1990, The accuracy of frozen‐section diagnoses in 34 hospitals, Arch Pathol Lab Med, 114, 355

Lee JG, 1974, Detection of residual carcinoma of the oral cavity, oropharynx, hypopharynx and larynx: a study of surgical margins, Trans Am Acad Ophthalmol Otolaryngol, 78, ORL49

10.1016/0002-9610(86)90304-1

10.1038/modpathol.2010.233

10.1002/hed.20269

10.1016/j.tripleo.2008.09.028

10.1016/0002-9610(78)90275-1

10.1002/1097-0142(19871015)60:8<1856::AID-CNCR2820600830>3.0.CO;2-5

Thông tin
Thông tin xuất bản

Head and Neck

Tập 36 Số 4

557-563

Thông tin tác giả