Eran Glikson1,2, Alberto Dragonetti3, Ethan Soudry4,5, Noa Rozendoren6, Eran E Alon6,4, Roee Landsberg7, Shay Schneider7, Lev Bedrin6, Francesco Mozzanica8,9, Chiara Bulgheroni8, Arkadi Yakirevitch6,4. 1. Department of Otolaryngology Head and Neck Surgery, The Sheba Medical Center, Tel Hashomer, Israel. Eran.Glikson@sheba.health.gov.il. 2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Eran.Glikson@sheba.health.gov.il. 3. Department of Otolaryngology, Ospedale Niguarda, Milan, Italy. 4. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 5. Department of Otolaryngology, Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel. 6. Department of Otolaryngology Head and Neck Surgery, The Sheba Medical Center, Tel Hashomer, Israel. 7. A.R.M. Center of Otolaryngology- Head and Neck Surgery, Assuta Medical Center, Tel Aviv, Israel. 8. Department of Otorhinolaryngology, Ospedale San Giuseppe IRCCS Multimedica, Milan, Italy. 9. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Abstract
PURPOSE: To explore the association between intraoperative surgical margin sampling by the frozen sections and recurrence in inverted papilloma surgery. METHODS: A multicenter, retrospective study of patients who underwent attachment-oriented IP resection in four tertiary care medical centers with a minimal follow-up of 36 months. RESULTS: The study included 220 surgeries with a mean follow-up period of 49 months (range 36-204). The endoscopic approach was used in all but 4 cases; 73% of procedures were primary. Overall recurrence was 10.45% (n = 23). Squamous cell carcinoma was found in 5 cases (2.2%). Intraoperative margin sampling was obtained in 145 cases. There was no difference in the recurrence rate between frozen section and no-frozen section groups (p = 0.44). Furthermore, margin sampling in various sites of tumor origin, in cases with concomitant nasal polyps (p = 0.53) and in revision cases (p = 0.08) showed no correlation with recurrence. In 26 cases when the surgery was extended following a positive frozen section, there was a significantly higher recurrence rate (OR = 6.94). CONCLUSIONS: According to our results, intraoperative margin sampling did not affect the recurrence rate of IP, and therefore, its routine use should be questioned.
PURPOSE: To explore the association between intraoperative surgical margin sampling by the frozen sections and recurrence in inverted papilloma surgery. METHODS: A multicenter, retrospective study of patients who underwent attachment-oriented IP resection in four tertiary care medical centers with a minimal follow-up of 36 months. RESULTS: The study included 220 surgeries with a mean follow-up period of 49 months (range 36-204). The endoscopic approach was used in all but 4 cases; 73% of procedures were primary. Overall recurrence was 10.45% (n = 23). Squamous cell carcinoma was found in 5 cases (2.2%). Intraoperative margin sampling was obtained in 145 cases. There was no difference in the recurrence rate between frozen section and no-frozen section groups (p = 0.44). Furthermore, margin sampling in various sites of tumor origin, in cases with concomitant nasal polyps (p = 0.53) and in revision cases (p = 0.08) showed no correlation with recurrence. In 26 cases when the surgery was extended following a positive frozen section, there was a significantly higher recurrence rate (OR = 6.94). CONCLUSIONS: According to our results, intraoperative margin sampling did not affect the recurrence rate of IP, and therefore, its routine use should be questioned.
Authors: Valerie J Lund; Heinz Stammberger; Piero Nicolai; Paolo Castelnuovo; Tim Beal; Alfred Beham; Manuel Bernal-Sprekelsen; Hannes Braun; Paola Cappabianca; Ricardo Carrau; Luigi Cavallo; George Clarici; Wolfwang Draf; Felice Esposito; Juan Fernandez-Miranda; Wytske Fokkens; Paul Gardner; Verena Gellner; Henrik Hellquist; Phillipe Hermann; Werner Hosemann; David Howard; Nick Jones; Mark Jorissen; Amin Kassam; Daniel Kelly; Senta Kurschel-Lackner; Samuel Leong; Nancy McLaughlin; Roberto Maroldi; Amir Minovi; Michael Mokry; Metin Onerci; Yew Kwang Ong; Daniel Prevedello; Hesham Saleh; Dharambir S Sehti; Daniel Simmen; Carl Snyderman; Auturo Solares; Magaret Spittle; Aldo Stamm; Peter Tomazic; Matteo Trimarchi; Frank Unger; Peter-John Wormald; Adam Zanation Journal: Rhinol Suppl Date: 2010-06-01
Authors: Antonio Minni; Davide Rosati; Carlo Cavaliere; Massimo Ralli; Giulio Sementilli; Andrea Gallo; Stefania Brozzetti; Paolo Ossola; Giuseppe Cavallaro; Marco Bononi Journal: Ear Nose Throat J Date: 2019-12-04 Impact factor: 1.697