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Resection status and margin control in intraoperative frozen sectioning analysis of oral squamous cell carcinoma.
- Source :
- Oral & Maxillofacial Surgery; Sep2024, Vol. 28 Issue 3, p1209-1218, 10p
- Publication Year :
- 2024
-
Abstract
- Purpose: Intraoperative frozen section analysis (IFSA) is a well-established procedure for determining the intraoperative soft tissue resection status in patients with oral squamous cell carcinoma (OSCC). Margin status is a major predictor of the patient´s outcome, histologically free margins of ≥ 5 mm are demanded. This study evaluates the accuracy of IFSA, the impact of margin status and the impact of intraoperative margin revision on disease-free survival (DFS) and overall survival (OS). Methods: This retrospective study included 213 patients with OSCC. IFSA results were compared with definitive histopathological reports, Kaplan–Meier analysis was performed. Cut-off values were calculated for resection margins considering known risk factors. Results: IFSA showed positive margins in 8 cases (3.8%). Kaplan–Meier analysis revealed no significant differences for OS or DFS if R0-status was achieved by initial resection or immediate re-resection. Final histopathological evaluation revealed false-positive IFSA in 3/8 cases (37.5%) and false-negative IFSA in 1/205 cases (0.5%). Sensitivity was 83.3% and specificity was 98.6%. Analysis of optimal cut-off values showed no general need for larger resection margins in patients with risk factors. Cut-off values were slightly higher for patients with the risk factor alcohol consumption (7 mm for OS and DFS) or pN + ECS- disease (7 mm for DFS). Optimal cut-off values for tumour-margin-distance were around 6 mm. Conclusion: IFSA provides a valuable assessment method for intraoperative soft tissue resection margins. Risk factors seemingly do not significantly influence the extent of tumour resection. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 18651550
- Volume :
- 28
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- Oral & Maxillofacial Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 179086471
- Full Text :
- https://doi.org/10.1007/s10006-024-01238-x