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Erschienen in: Indian Journal of Otolaryngology and Head & Neck Surgery 1/2015

01.03.2015 | Original Article

Prognostic Value of Frozen Section in T1, T2 Carcinoma of Oral Cavity

verfasst von: Sandhya Gokavarapu, L. M. Chandrasekhara Rao, Sujit Chau Patnaik, Nagendra Parvataneni, K. V. V. N. Raju, Ravi Chander

Erschienen in: Indian Journal of Otolaryngology and Head & Neck Surgery | Sonderheft 1/2015

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Abstract

Complex anatomy of oral cavity makes it difficult for a surgeon to assess margins of oral cancer accurately and positive margins compromise loco regional disease control, thus surgeon may rely on frozen section assessment for marginal status. We discussed the prognostic value of frozen section in early carcinoma of oral cavity. 90 patients with pT1 and pT2 oral cavity cancer operated from January 2010 to December 2011 under single consultant surgeon were retrospectively evaluated. Log rank test and multivariate cox regression model was used for testing frozen section against the survival and recurrence free status. Survival of patients with positive or negative frozen section was significant (p = 0.037), Survival of patients with positive or negative histology report was significant (p = 0.004), however; prognosis of patients with positive margins despite revision under frozen control was poorer to the patients with negative margin. Frozen section assessment is accurate but their use in the surgery of oral cavity cancer might not improve loco regional disease control or survival when used routinely.
Literatur
1.
Zurück zum Zitat Kaufman Z, Lew S, Griffel B et al (1986) Frozen-section diagnosisin surgical pathology: a prospective analysis of 526 frozen sections. Cancer 57:377PubMedCrossRef Kaufman Z, Lew S, Griffel B et al (1986) Frozen-section diagnosisin surgical pathology: a prospective analysis of 526 frozen sections. Cancer 57:377PubMedCrossRef
2.
Zurück zum Zitat Rogers C, Klatt EC, Chandrasoma P (1987) Accuracy of frozen section diagnosis in a teaching hospital. Arch Pathol Lab Med 111:514PubMed Rogers C, Klatt EC, Chandrasoma P (1987) Accuracy of frozen section diagnosis in a teaching hospital. Arch Pathol Lab Med 111:514PubMed
3.
Zurück zum Zitat Howanitz PJ, Hoffman GG, Zarbo RJ (1990) The accuracy of frozen section diagnoses in 34 hospitals. Arch Pathol Lab Med 114:355PubMed Howanitz PJ, Hoffman GG, Zarbo RJ (1990) The accuracy of frozen section diagnoses in 34 hospitals. Arch Pathol Lab Med 114:355PubMed
4.
Zurück zum Zitat Ord Robert A, Aisner S (1997) Accuracy of frozen sections in assessing margins in oral cancer resection. J Oral Maxillofac Surg 55:663–669PubMedCrossRef Ord Robert A, Aisner S (1997) Accuracy of frozen sections in assessing margins in oral cancer resection. J Oral Maxillofac Surg 55:663–669PubMedCrossRef
5.
Zurück zum Zitat Batsakis JG (1999) Surgical excision margins: a pathologist’s perspective. Adv Anat Pathol 6:140–148PubMedCrossRef Batsakis JG (1999) Surgical excision margins: a pathologist’s perspective. Adv Anat Pathol 6:140–148PubMedCrossRef
6.
Zurück zum Zitat Brandwein-Gensler M, Teixeira MS et al (2005) Squamous cell carcinoma histologic risk assessment, but not margin status, is strongly predictive of local disease-free and overall survival. Am J Surg Pathol 29(2):167–178PubMedCrossRef Brandwein-Gensler M, Teixeira MS et al (2005) Squamous cell carcinoma histologic risk assessment, but not margin status, is strongly predictive of local disease-free and overall survival. Am J Surg Pathol 29(2):167–178PubMedCrossRef
7.
Zurück zum Zitat Woolgar JA, Triantafyllou A (2005) A histopathological appraisal of surgical margins in oral and oropharyngeal cancer resection specimens. Oral Oncol 41:1034–1043PubMedCrossRef Woolgar JA, Triantafyllou A (2005) A histopathological appraisal of surgical margins in oral and oropharyngeal cancer resection specimens. Oral Oncol 41:1034–1043PubMedCrossRef
8.
Zurück zum Zitat Helliwell T, Woolgar JA (2005) Standards and minimum datasets for reporting cancers. Dataset for histopathologic reports on head and neck carcinomas and salivaryneoplasms, 2nd edn. Royal College of Pathologists, London Helliwell T, Woolgar JA (2005) Standards and minimum datasets for reporting cancers. Dataset for histopathologic reports on head and neck carcinomas and salivaryneoplasms, 2nd edn. Royal College of Pathologists, London
9.
Zurück zum Zitat Loree TR, Strong EW (1990) Significance of positive margins in oral cavity squamous carcinoma. Am J Surg 160:410–414PubMedCrossRef Loree TR, Strong EW (1990) Significance of positive margins in oral cavity squamous carcinoma. Am J Surg 160:410–414PubMedCrossRef
10.
Zurück zum Zitat Binahmed A, Nason RW, Abdoh AA (2007) The clinical significance of positive surgical margin in oral cancer. Oral Oncol 43:780–784PubMedCrossRef Binahmed A, Nason RW, Abdoh AA (2007) The clinical significance of positive surgical margin in oral cancer. Oral Oncol 43:780–784PubMedCrossRef
11.
Zurück zum Zitat Byers RM, Bland KI, Borlase B, Luna M (1978) The prognostic and therapeutic value of frozen section determination in the surgical treatment of squamous carcinoma of the head and neck. Am J Surg 136:525–528PubMedCrossRef Byers RM, Bland KI, Borlase B, Luna M (1978) The prognostic and therapeutic value of frozen section determination in the surgical treatment of squamous carcinoma of the head and neck. Am J Surg 136:525–528PubMedCrossRef
12.
Zurück zum Zitat Pathak KA, Nason RW, Penner C, Viallet NR, Sutherland D, Kerr PD (2009) Impact of frozen section assessment of operative margins on survival in oral cancer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 107:235–239PubMedCrossRef Pathak KA, Nason RW, Penner C, Viallet NR, Sutherland D, Kerr PD (2009) Impact of frozen section assessment of operative margins on survival in oral cancer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 107:235–239PubMedCrossRef
13.
Zurück zum Zitat Kerawala CJ, Ong TK (2001) Relocating the site of frozen sections-Is there room for improvement? Head Neck 23:230–232PubMedCrossRef Kerawala CJ, Ong TK (2001) Relocating the site of frozen sections-Is there room for improvement? Head Neck 23:230–232PubMedCrossRef
14.
Zurück zum Zitat Lee JG (1974) Detection of residual carcinoma of the oral cavity, oropharynx, hypopharynx and larynx: a study of surgical margins. Trans Am Acad Ophthalmol Otolaryngol 78:49–53 Lee JG (1974) Detection of residual carcinoma of the oral cavity, oropharynx, hypopharynx and larynx: a study of surgical margins. Trans Am Acad Ophthalmol Otolaryngol 78:49–53
15.
Zurück zum Zitat Chen TY, Emrich LJ, Driscoll DL (1987) The clinical significance of pathological findings in surgically resected margins of the primary tumor in head and neck Carcinoma. Int J Radiat Oncol Biol Phys 13:833–837PubMedCrossRef Chen TY, Emrich LJ, Driscoll DL (1987) The clinical significance of pathological findings in surgically resected margins of the primary tumor in head and neck Carcinoma. Int J Radiat Oncol Biol Phys 13:833–837PubMedCrossRef
16.
Zurück zum Zitat Kovacs AF (2004) Relevance of positive margins in case of adjuvant therapy of oral cancer. Int J Oral Maxillofac Surg 33:447–453PubMedCrossRef Kovacs AF (2004) Relevance of positive margins in case of adjuvant therapy of oral cancer. Int J Oral Maxillofac Surg 33:447–453PubMedCrossRef
17.
Zurück zum Zitat Bernier J, Cooper JS, Pajak TF, van Glabbeke M, Bourhis J, Forastiere A, Ozsahin EM, Jacobs JR, Jassem J, Ang KK (2005) Lefèbvre Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (# 9501). Head Neck 27(10):843–850PubMedCrossRef Bernier J, Cooper JS, Pajak TF, van Glabbeke M, Bourhis J, Forastiere A, Ozsahin EM, Jacobs JR, Jassem J, Ang KK (2005) Lefèbvre Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (# 9501). Head Neck 27(10):843–850PubMedCrossRef
18.
Zurück zum Zitat Chievitz JH (1885) Beitrage zur Entwicklungsgeschichte der Speicheldrusen. Arch Anat Physiol 9:401–436 Chievitz JH (1885) Beitrage zur Entwicklungsgeschichte der Speicheldrusen. Arch Anat Physiol 9:401–436
19.
Zurück zum Zitat Eversole LR, Leider AS (1978) Maxillary intraosseous neuroepithelial structures resembling those seen in the organ of Chievitz. Oral Surg Oral Med Oral Pathol 46:555–558PubMedCrossRef Eversole LR, Leider AS (1978) Maxillary intraosseous neuroepithelial structures resembling those seen in the organ of Chievitz. Oral Surg Oral Med Oral Pathol 46:555–558PubMedCrossRef
20.
Zurück zum Zitat Danforth RA, Baughman RA (1979) Chievitz’s organ: a potential pitfall in oral cancer diagnosis. Oral Surg Oral Med Oral Pathol 48:231–236PubMedCrossRef Danforth RA, Baughman RA (1979) Chievitz’s organ: a potential pitfall in oral cancer diagnosis. Oral Surg Oral Med Oral Pathol 48:231–236PubMedCrossRef
21.
Zurück zum Zitat Miko T, Molnar P (1981) The juxtaoral organ: a pitfall for pathologists. J Pathol 133:17–23PubMedCrossRef Miko T, Molnar P (1981) The juxtaoral organ: a pitfall for pathologists. J Pathol 133:17–23PubMedCrossRef
22.
Zurück zum Zitat Spiro RH, Guillamondegui O, Paulino AF, Huvos AG (1999) Pattern of invasion and margin assessment in patients with oral tongue cancer. Head Neck 21:408–413PubMedCrossRef Spiro RH, Guillamondegui O, Paulino AF, Huvos AG (1999) Pattern of invasion and margin assessment in patients with oral tongue cancer. Head Neck 21:408–413PubMedCrossRef
Metadaten
Titel
Prognostic Value of Frozen Section in T1, T2 Carcinoma of Oral Cavity
verfasst von
Sandhya Gokavarapu
L. M. Chandrasekhara Rao
Sujit Chau Patnaik
Nagendra Parvataneni
K. V. V. N. Raju
Ravi Chander
Publikationsdatum
01.03.2015
Verlag
Springer India
Erschienen in
Indian Journal of Otolaryngology and Head & Neck Surgery / Ausgabe Sonderheft 1/2015
Print ISSN: 2231-3796
Elektronische ISSN: 0973-7707
DOI
https://doi.org/10.1007/s12070-014-0783-6

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