Intraoperative gross examination vs frozen section for achievement of adequate margin in oral cancer surgery
| Autor: | Pankaj Chaturvedi, Apoorva Garg, Sudhir Nair, Rathan Shetty Ks, Sourav Dutta, Manish Mair, Akshat Malik, Aseem Mishra, Deepa Nair |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Surgical margin Oral Surgical Procedures Sensitivity and Specificity Pathology and Forensic Medicine Gross examination 03 medical and health sciences 0302 clinical medicine Margin (machine learning) Adjuvant therapy Frozen Sections Humans Medicine Neoplasm Invasiveness Radiology Nuclear Medicine and imaging Dentistry (miscellaneous) 030223 otorhinolaryngology Aged Neoplasm Staging Retrospective Studies Aged 80 and over Frozen section procedure Intraoperative Care business.industry Incidence (epidemiology) Medical record Margins of Excision Cancer Middle Aged Prognosis medicine.disease Surgery 030220 oncology & carcinogenesis Female Mouth Neoplasms Neoplasm Grading Oral Surgery business |
| Zdroj: | Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 123:544-549 |
| ISSN: | 2212-4403 |
| DOI: | 10.1016/j.oooo.2016.11.018 |
| Popis: | Objective Surgical margin status is an important prognostic factor in oral squamous cell carcinoma. The primary aim of the surgeon is to achieve a microscopically complete surgical resection during initial surgery. As there are no definite guidelines, a few surgeons use frozen section (FS) for margin assessment whereas others use gross examination (GE). Study Design This is a retrospective analysis of prospectively collected data from the electronic medical records of 435 oral cavity cancer patients. As per the operating surgeon's preference, margin assessment was done using GE in 239 (54.94%) specimens, and FS was used in 196 (45.05%) specimens. Surgery was the primary modality of treatment for all patients, followed by adjuvant therapy. Results Close/positive margins were seen in 6.63% of patients in the FS group and in 6.69% of patients in the GE group (P = .855). The sensitivity and specificity were 45.45% and 98.8%, respectively, for FS and 61.9% and 88.32% for GE. We found no survival benefit when FS was used for margin assessment (disease-free survival: P = .469; overall survival: 0.325). Incidence of inadequate margins was similar in both the groups (P = .608) even in patients with some form of previous treatment. Conclusion We propose the judicious use of FS rather than routine use for margin assessment. The study reports that GE is an well-tolerated oncologic alternative to FS. |
| Databáze: | OpenAIRE |
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