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.
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 cancerpatients. 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.
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: Elvis Duran-Sierra; Shuna Cheng; Rodrigo Cuenca-Martinez; Bilal Malik; Kristen C Maitland; Y S Lisa Cheng; John Wright; Beena Ahmed; Jim Ji; Mathias Martinez; Moustafa Al-Khalil; Hussain Al-Enazi; Javier A Jo Journal: Oral Oncol Date: 2020-04-02 Impact factor: 5.337
Authors: Roeland W H Smits; Cornelia G F van Lanschot; Yassine Aaboubout; Maria de Ridder; Vincent Noordhoek Hegt; Elisa M Barroso; Cees A Meeuwis; Aniel Sewnaik; Jose A Hardillo; Dominiek Monserez; Stijn Keereweer; Hetty Mast; Ivo Ten Hove; Tom C Bakker Schut; Robert J Baatenburg de Jong; Gerwin J Puppels; Senada Koljenović Journal: Front Oncol Date: 2020-12-23 Impact factor: 6.244
Authors: Elisa M Barroso; Yassine Aaboubout; Lisette C van der Sar; Hetty Mast; Aniel Sewnaik; Jose A Hardillo; Ivo Ten Hove; Maria R Nunes Soares; Lars Ottevanger; Tom C Bakker Schut; Gerwin J Puppels; Senada Koljenović Journal: Front Oncol Date: 2021-03-30 Impact factor: 6.244
Authors: Yassine Aaboubout; Ivo Ten Hove; Roeland W H Smits; Jose A Hardillo; Gerwin J Puppels; Senada Koljenovic Journal: Oral Dis Date: 2020-09-13 Impact factor: 3.511