BACKGROUND: Opinions differ regarding the usefulness of accurate, but costly, frozen sections. Most physicians believe that negative margins are essential for the prognosis of patients with oral and pharyngeal cancer. We examined whether immediate repeated resections in patients with positive margins, based on findings from frozen sections, resulted in improved patient survival. METHODS: Data from 417 patients identified with cancer of the pharynx and floor of the mouth were analyzed retrospectively. RESULTS: The 5-year survival rate for R0 and R1-R0 groups was 72% to 76% and was significantly better (p ≤ .034) than that for R1 and R2 groups (58%, 40%). Despite clear margins, large tumors had a poorer prognosis than that of small tumors. CONCLUSIONS: Patients receiving repeated resection had the same survival rate as patients who had the tumor resected immediately with negative margins. The use of frozen sections yields a benefit for 15.6% of the operated patients and increases the overall 5-year survival rate by 2% to 3%.
BACKGROUND: Opinions differ regarding the usefulness of accurate, but costly, frozen sections. Most physicians believe that negative margins are essential for the prognosis of patients with oral and pharyngeal cancer. We examined whether immediate repeated resections in patients with positive margins, based on findings from frozen sections, resulted in improved patient survival. METHODS: Data from 417 patients identified with cancer of the pharynx and floor of the mouth were analyzed retrospectively. RESULTS: The 5-year survival rate for R0 and R1-R0 groups was 72% to 76% and was significantly better (p ≤ .034) than that for R1 and R2 groups (58%, 40%). Despite clear margins, large tumors had a poorer prognosis than that of small tumors. CONCLUSIONS:Patients receiving repeated resection had the same survival rate as patients who had the tumor resected immediately with negative margins. The use of frozen sections yields a benefit for 15.6% of the operated patients and increases the overall 5-year survival rate by 2% to 3%.
Authors: Mark W Kubik; Shaum Sridharan; Mark A Varvares; Dan P Zandberg; Heath D Skinner; Raja R Seethala; Simion I Chiosea Journal: Head Neck Pathol Date: 2020-03-02
Authors: Jessica H Maxwell; Lester D R Thompson; Margaret S Brandwein-Gensler; Bernhard G Weiss; Martin Canis; Bibianna Purgina; Arpan V Prabhu; Chi Lai; Yongli Shuai; William R Carroll; Anthony Morlandt; Umamaheswar Duvvuri; Seungwon Kim; Jonas T Johnson; Robert L Ferris; Raja Seethala; Simion I Chiosea Journal: JAMA Otolaryngol Head Neck Surg Date: 2015-12 Impact factor: 6.223
Authors: Arpan V Prabhu; Charles D Sturgis; Chi Lai; Jessica H Maxwell; Mihai Merzianu; Juan C Hernandez-Prera; Bibianna Purgina; Lester D R Thompson; Madalina Tuluc; Xiu Yang; Raja R Seethala; Robert L Ferris; Simion I Chiosea Journal: Oral Oncol Date: 2017-11-01 Impact factor: 5.337