Impact of intraoperative frozen section analysis on outcome in oral squamous cell carcinoma.

Abstract

Introduction: The research is focused on the reliability of Intraoperative Frozen Section Analysis (IFSA) to detect positive margins during surgical extirpation of Oral Squamous Cell Carcinoma (OSCC).

Material and methods: Seventy-eight patients who were surgically treated for OSCC in Virgen de las Nieves University Hospital between 2019 and 2023 were included in the study. For all patients IFSA was performed during the surgery and, after the surgery, every sample underwent a complete histological analysis. Data regarding localization, T, N, TNM stage, cervical and local recurrence were collected and studied in relation to IFSA status and surgical margins.

Results: 25 patients out of 78 resulted as "false negatives", pointing out a sensitivity of 13,8 % and a specificity of 100 %; a statistical significant relation emerged regarding tumor dimension (T) and TNM in relation to IFSA and surgical margins, highlighting that reliability of IFSA decreases for advanced stage OSCC.

Discussion: IFSA represents an interesting technique to assess margin status during surgical extirpation of OSCC mainly in early stages; an accurate planning of an extended surgical margin, above all in advanced stages, could improve the control of the tumor. Further multicenter studies are needed to clarify the reliability of this technique.