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Gross examination by the surgeon as an alternative to frozen section for assessment of adequacy of surgical margin in head and neck squamous cell carcinoma
Author(s) -
Chaturvedi Pankaj,
Datta Sourav,
Nair Sudhir,
Nair Deepa,
Pawar Prashant,
Vaishampayan Sagar,
Patil Asawari,
Kane Shubhada
Publication year - 2014
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23313
Subject(s) - frozen section procedure , medicine , margin (machine learning) , gross examination , head and neck squamous cell carcinoma , head and neck , surgery , surgical margin , basal cell , radiology , head and neck cancer , pathology , radiation therapy , resection , machine learning , computer science
Background The cost‐effectiveness of the frozen section for assessment of margin in head and neck squamous cell carcinoma (HNSCC) is still contentious. The purpose of this study was to evaluate whether gross examination of margin is an alternative to frozen section. Methods It was a prospective observational study in 145 consecutive patients undergoing surgery for HNSCC. Surgical margins were first assessed by the surgeons with a metallic scale. All specimens were then examined using frozen section and permanent section. Results Overall, 83% of inadequate margins were detected by frozen section. The chances of inadequate margin were very low if gross surgical margin were 7 mm or more. Gross examination alone (with 7 mm as cutoff) predicted 88% of the inadequate surgical margin. There was no difference in precision of frozen section vis‐à‐vis gross examination with 7 mm cut off ( p ≤ .8). Conclusion Achievement of 7 mm surgical margin measured by a surgeon obviates the need for frozen section. © 2013 Wiley Periodicals, Inc. Head Neck 36 : 557–563, 2014