Poster Presentation Joint Scientific Meeting of the Australian & NZ Head & Neck Cancer Society & NZ Association of Plastic Surgeons

The utility of frozen section pathology in oral squamous cell carcinoma - A systematic review  (1379)

Linus T D Armstrong 1 , Nicholas Beech 1 , Martin Batstone 1
  1. Oral and Maxillofacial Surgery, Royal Brisbane and Women's Hospital, Herston, QLD, Australia

Background: Oral squamous cell carcinoma (SCC) is the most common head and neck malignancy with approximately 200,000 cases diagnosed each year and 100,000 patient deaths annually. Due to the complex oral anatomy and decreased visual and physical access, achieving adequate surgical margins on primary excision of oral SCC can be challenging. Frozen section histopathological analysis aims to examine tissue samples intraoperatively and assess the adequacy of tumour resection margins to guide further treatment. The literature surrounding its use and impact on improving final margin status, recurrence and survival in cases of oral SCC is mixed.

Objectives: This study aimed to systematically review the literature and compare final margin status, locoregional recurrence and overall survival between cases of oral SCC surgically resected with frozen section intraoperative analysis versus gross examination of the tumour specimen alone.

Methods: A systematic review was conducted adhering to the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. A search was performed in EMBASE, PubMed, Cochrane Library and Scopus. No date or language restrictions were applied. Observational and experimental studies that directly compared one or more of the primary outcomes between the two cohorts were considered for inclusion.

Results: Five studies met the inclusion criteria. Due to a paucity of data and study heterogeneity a met-analysis was not performed. There was no significant difference in final margin status, disease free survival or overall survival between cases of oral SCC resected with the use of frozen section intraoperatively and with clinical examination alone.

Conclusion: As a result of the current findings, including but not limited to the significant monetary cost incurred and the time required, the routine use of frozen section analysis in the surgical treatment of oral SCC is not recommended.

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