Frozen section analysis of margins for head and neck tumor resections: reduction of sampling errors with a third histologic level.

Author(s): Olson SM, Hussaini M, Lewis JS Jr

Publication: Mod Pathol, 2011, Vol. 24, Page 665-70

PubMed ID: 21217647 PubMed Review Paper? No

Purpose of Paper

Conclusion of Paper

Studies

1. Study Purpose

   The purpose of this study was to determine the effects of analyzing 3 rather than 2 frozen section margins intra-operatively to determine whether complete resection of tumor was achieved.

   Summary of Findings:

   When two frozen section margins were analyzed intra-operatively, the sampling and interpretation error rates were 1.6% and 0.8%, respectively for a combined error rate of 2.4%. When an additional third frozen section margin from a deeper level was examined, the sampling and interpretation error rates were 1.2% and 1.3%, respectively (2.5% overall), and were not significantly different from the two-level sectioning analysis. However, when specimens for which no tumor or dysplasia was identified on the frozen sections or an FFPE section were excluded, two-level sectioning error rates were significantly higher than three-level sectioning error rates, for both overall rates (22.9% versus 15.2%, p=0.03) and sampling error rates (15.3% versus 7.4%, p=0.006), but not for interpretation error rates (7.6% versus 7.8%, p=1.0). A significantly higher percentage of margins were found to harbor tumor in the frozen sections during the period when 3 section were analyzed (16.7%) compared to during the period when 2 sections were analyzed (10.5%, p<0.0001). Keratinizing squamous cell carcinoma was the only tumor subtype examined that showed a significant increase in positive margin sampling error rates between two-level sectioning and three-level sectioning.

   Biospecimens

   • Tissue - Head and Neck

   Preservative Types

   • Frozen
   • Formalin

   Diagnoses:

   • Neoplastic - Carcinoma
   • Neoplastic - Benign

   Platform:

   Analyte	Technology Platform
   Morphology	Light microscopy

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Biospecimen Aliquots and Components	Aliquot size/volume	2 frozen sections and 1 paraffin section examined 3 frozen sections and 1 paraffin section examined
   Preaquisition	Diagnosis/ patient condition	Keratinizing squamous cell carcinoma Non-keratinizing squamous cell carcinoma Other tumors

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