Relocating the site of frozen sections?Is there room for improvement?

Kerawala, Cyrus; Ong, T.K.

doi:10.1002/1097-0347(200103)23:3<230::aid-hed1023>3.0.co;2-v

Cited by 79 publications

(78 citation statements)

References 11 publications

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“…This finding is somewhat counterintuitive as in the revision scenario tumor bed sampling was guided by the results of margins’ assessment from the resection specimen. This finding confirms the challenges of re-localizing the area of concern in the tumor bed [21]. …”

Section: Resultssupporting

confidence: 84%

Improving margin revision: Characterization of tumor bed margins in early oral tongue cancer

et al. 2017

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Objectives To improve margin revision, this study characterizes the number, fragmentation, and orientation of tumor bed margins (TBM) in patients with pT1-2 pN0 squamous cell carcinoma (SCC) of the oral tongue. Materials and Methods Pathology reports (n = 346) were reviewed. TBM parameters were indexed. In Group 1 patients all margins were obtained from the glossectomy specimen and there were no TBM. In Revision Group/Group 2 (n = 103), tumor bed was sampled to revise suboptimal margins identified by examination of the glossectomy specimen. In Group 3 (n = 124), TBM were obtained before examination of the glossectomy specimen. Results and Conclusions Fewer TBMs were obtained per patient in Group 2 compared to Group 3 (57/103, 55% of patients with < 3 vs. 117/124, 94%, ≥3 TBMs, respectively). The new margin surface was more frequently indicated in Group 2 compared to Group 3 (59/103, 57%, vs. 19/124, 15%, p < .001). If glossectomy specimen margins are accepted as the reference standard, then the TBM was 15% sensitive in Group 2 (95% confidence interval [CI], 7–29) and 32% sensitive in Group 3 (95% CI, 15–55). TBM fragmentation (23/103, 22% vs. 42/124, 34%) and frozen vs. permanent discrepancies (8/103, 3% vs. 3/124, 2%) were similar between Groups 2 and 3. The new margin surface was not indicated in 6 of 11 cases with discrepant frozen vs. permanent pathology findings, precluding judgment on final margin status. To facilitate the assessment of final margins, TBM should be represented by one tissue fragment with a marked new margin surface.

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Section: Resultssupporting

confidence: 84%

Improving margin revision: Characterization of tumor bed margins in early oral tongue cancer

et al. 2017

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“…In a prospective study of Kerawala and Ong evaluating one surgeon in 14 cases the mean error in relocating a sample site was 9 mm for mucosal margins and 12 mm for deep margins. The error was more than 1 cm in 32% of cases [22]. Especially carcinomas with muscle infiltration of the tongue or cheek area tend to withdraw after initial resection.…”

Section: Discussionmentioning

confidence: 92%

Positive frozen section margins predict local recurrence in R0-resected squamous cell carcinoma of the head and neck

et al. 2016

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“…Other problems that have been encountered concern the site where the FS should be collected (surgical bed vs specimen) [30] and the risk of not precisely identifying the area to be enlarged in the event of positive margins [35]. Possible solutions have, however, been proposed [36].…”

Section: Discussionmentioning

confidence: 99%

Narrow band imaging in the intra-operative definition of resection margins in oral cavity and oropharyngeal cancer

et al. 2015

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Relocating the site of frozen sections?Is there room for improvement?

Cited by 79 publications

References 11 publications

Improving margin revision: Characterization of tumor bed margins in early oral tongue cancer

Improving margin revision: Characterization of tumor bed margins in early oral tongue cancer

Positive frozen section margins predict local recurrence in R0-resected squamous cell carcinoma of the head and neck

Narrow band imaging in the intra-operative definition of resection margins in oral cavity and oropharyngeal cancer

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