False-negative rate of intraoperative frozen section margin analysis for complex head and neck nonmelanoma skin cancer excisions

2015 ◽  
Vol 40 (8) ◽  
pp. 834-838 ◽  
Author(s):  
M. D. Moncrieff ◽  
A. K. Shah ◽  
L. Igali ◽  
J. J. Garioch
Keyword(s):  
Skin Cancer ◽  
Head And Neck ◽  
Frozen Section ◽  
False Negative ◽  
False Negative Rate ◽  
Nonmelanoma Skin Cancer ◽  
Intraoperative Frozen Section ◽  
Negative Rate ◽  
Margin Analysis

Intraoperative Frozen Section Analysis for the Excision of Nonmelanoma Skin Cancer: A Single-Center Experience

2019 ◽  
Vol 85 (12) ◽  
pp. 1397-1401
Author(s):  
Tylert Bilden ◽  
Katherine C. Benedict ◽  
Patrick W. Lamb ◽  
Jaron Mcmullin
Keyword(s):  
Skin Cancer ◽  
Predictive Value ◽  
Frozen Section ◽  
False Negative ◽  
Surgical Excision ◽  
Nonmelanoma Skin Cancer ◽  
Intraoperative Frozen Section ◽  
Frozen Section Analysis ◽  
Delayed Reconstruction ◽  
Section Analysis

Surgical resection of nonmelanoma skin cancer (NMSC) may be performed via Mohs micrographic surgery (MMS) or standard surgical excision with complete margin analysis. Whereas MMS may necessitate delayed reconstruction surgery, intraoperative frozen section analysis (IFSA) may be used to ensure clear surgical margins before proceeding with reconstruction. To achieve curative resection while optimizing aesthetic outcomes, surgeons may use surgical excision guided by IFSA to forego extensive or delayed reconstruction. Patients undergoing wide local excision for NMSC using IFSA from October 2008 to November 2016 were evaluated. Analysis included IFSA versus permanent section outcomes, the number of required excisions, and the recurrence rate. Our analysis contained 145 patients involving 162 lesions. IFSA demonstrated that 73.4 per cent of margins were negative after one excision and 26.5 per cent were re-excised until achieving negative margins. Analysis revealed one false-positive case (0.62%) and four false-negative cases (2.47%). Nine patients had local recurrence (5.56%). Frozen section sensitivity was 88.99 per cent and specificity 99.20 per cent. The positive predictive value was 96.97 per cent, and negative predictive value was 96.90 per cent. Mean follow-up time was 39 months. Both resection and recurrence data of excised NMSC lesions at our institution suggest that surgical excision using IFSA is a safe and effective alternative to MMS.

scholarly journals 489 The Role of Sentinel Lymph Node Biopsy in Cutaneous Head and Neck Melanoma: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
E Johnston ◽  
S Taylor ◽  
F Bannon ◽  
S McAllister
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Head And Neck ◽  
False Negative ◽  
False Negative Rate ◽  
Lymph Node Biopsy ◽  
Node Biopsy ◽  
Negative Rate ◽  
Sentinel Node Identification

Abstract Introduction and Aims The aim of this systematic review is to provide an up-to-date evaluation of the role and test performance of sentinel lymph node biopsy (SLNB) in the head and neck. Method This review follows the PRISMA guidelines. Database searches for MEDLINE and EMBASE were constructed to retrieve human studies published between 1st January 2010 and 1st July 2020 assessing the role and accuracy of sentinel lymph node biopsy in cutaneous malignant melanoma of the head and neck. Articles were independently screened by two reviewers and critically appraised using the MINORS criteria. The primary outcomes consisted of the sentinel node identification rate and test-performance measures, including the false-negative rate and the posttest probability negative. Results A total of 27 studies, including 4688 patients, met the eligibility criteria. Statistical analysis produced weighted summary estimates for the sentinel node identification rate of 97.3% (95% CI, 95.9% to 98.6%), the false-negative rate of 21.3% (95% CI, 17.0% to 25.4%) and the posttest probability negative of 4.8% (95% CI, 3.9% to 5.8%). Discussion Sentinel lymph node biopsy is accurate and feasible in the head and neck. Despite technical improvements in localisation techniques, the false negative rate remains disproportionately higher than for melanoma in other anatomical sites.

Does the number of sentinel lymph nodes removed affect the false negative rate for head and neck melanoma?

2018 ◽  
Vol 117 (7) ◽  
pp. 1584-1588 ◽  
Author(s):  
Charles J. Puza ◽  
Srirama Josyula ◽  
Alicia M. Terando ◽  
John H. Howard ◽  
Doreen M. Agnese ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Head And Neck ◽  
False Negative ◽  
False Negative Rate ◽  
Sentinel Lymph Nodes ◽  
Negative Rate ◽  
Head And Neck Melanoma

Performance of a 31-gene expression profile (GEP) test for metastatic risk prediction in cutaneous melanomas (CM) of the head and neck.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 9576-9576
Author(s):  
John T. Vetto ◽  
Sancy Ann Leachman ◽  
Brooke Middlebrook ◽  
Kyle R. Covington ◽  
Jeffrey D. Wayne ◽  
...  
Keyword(s):  
High Risk ◽  
Head And Neck ◽  
Distant Metastasis ◽  
False Negative ◽  
Tumor Biology ◽  
False Negative Rate ◽  
Neck Region ◽  
Negative Rate ◽  
Class 1 ◽  
Metastatic Risk

9576 Background: Accurate prognostication of distant metastatic risk using sentinel lymph node (SLN) biopsy for CM can be challenging in melanomas of the head and neck due to a higher false negative rate compared to other anatomical areas. A GEP signature that predicts metastatic risk based on primary tumor biology, providing a binary outcome of Class 1 (low risk of metastasis) or Class 2 (high risk), was previously described. The prognostic capabilities of the GEP independently and in combination with SLN status in a cohort of patients with primary head and neck CM are assessed here. Methods: All samples and clinical data were collected under an IRB-approved multicenter protocol. qPCR analysis was used to assess expression of the gene signature (Class 1 vs. Class 2). Distant metastasis-free survival (DMFS) and melanoma-specific survival (MSS) were assessed. Results: 157 subjects with primary CMs in the head and neck region were identified. 110 of 157 subjects had a SLN biopsy performed. Median age was 65 years (range 25-89) and median Breslow depth was 1.6 mm (range 0.2-15.0 mm). In 71 SLN-negative patients, 18 of 27 (67%) distant metastatic events were GEP Class 2. Overall, 73% (47 of 64) distant metastases, and 88% (22 of 25) deaths due to CM were called Class 2. By comparison, sensitivities for DMFS and MSS were 41% (26 of 64) and 52% (13 of 25), respectively, using SLN biopsy alone, and increased to 80% (51 of 64) and 88% (22 of 25), respectively, when combining the SLN status and GEP class. Kaplan-Meier 5-year DMFS and MSS rates based on SLN status alone or in combination with GEP are shown in the table. Conclusions: These data support the ability of the GEP test to accurately identify low- and high-risk cases of head and neck melanoma. The results strongly support the role of GEP testing to enhance current staging by better predicting the risk of distant metastasis and death for patients with melanoma in an anatomic region that is associated with a higher SLN biopsy false negative rate. [Table: see text]

Re-Evaluate the Value of Frozen Sections in Diagnoses of Breast Malignancies that Failed to be Diagnosed by Core Needle Biopsy: A Chinese Retrospective Analysis of Clinical Practice

2021 ◽  
Author(s):  
Jialei Xue ◽  
Jianwei Li ◽  
Yue Gong ◽  
Qiuxia Cui ◽  
Li Dai ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Frozen Section ◽  
False Negative ◽  
False Negative Rate ◽  
Frozen Sections ◽  
Core Needle ◽  
Negative Rate ◽  
Breast Malignancies

Abstract Objective: The value of frozen sections in diagnoses of breast malignancies that failed to be diagnosed by core needle biopsy (CNB) is indeterminate. To re-evaluate and improve the utility of frozen section on this kind of breast malignancy, we conducted a retrospective data analysis and constructed a prediction model.Method: We reviewed data of breast cancer patients that failed to be diagnosed by CNB (CNB-undiagnosable) in Fudan University Shanghai Cancer Center (FUSCC) from May 1, 2006 to December 31, 2019. Clinical characteristics of patients were collected. the correlation between clinical features and false negative rate (FNR) of frozen sections was explored with logistic regression analysis, after which a nomogram was constructed to predict the probability of false negative.Result: The diagnostic sensitivity of frozen section on CNB-undiagnosable breast cancer was 67.18%, and the FNR was 32.82%. In multivariate analysis, papillary lesion (OR, 4.251; 95% CI, 2.804-6.492; P<0.0001) and sclerosing adenosis (OR, 3.727; 95% CI, 1.897-7.376; P= 0.0001) on CNB were risk factors of false negative, while clustered microcalcifications on mammography (OR, 0.345; 95% CI, 0.216-0.543; P < 0.0001) and ultrasonic BI-RADS category 4C-5 (OR, 0.250; 95% CI, 0.081-0.777; P = 0.0157) were favorable factors of true positive. The false negative rate of frozen section could be controlled at about 10% by the prediction of nomogram. Conclusion: Frozen sections are valuable in the diagnosis of CNB-undiagnosable breast cancers. It is recommended to implement the intraoperative frozen sections for high-risk breast lesions with a low probability of false negative indicated by prediction, so as to minimize the occurrence of unnecessary re-operation.

Frozen section analysis of SLNs in trunk and extremity melanoma has a high false negative rate but can spare some patients a second operation

2016 ◽  
Vol 114 (7) ◽  
pp. 879-883 ◽  
Author(s):  
Aodhnait S. Fahy ◽  
Travis E. Grotz ◽  
Gary L. Keeney ◽  
Amy E. Glasgow ◽  
Elizabeth B. Habermann ◽  
...  
Keyword(s):  
Frozen Section ◽  
False Negative ◽  
False Negative Rate ◽  
Negative Rate ◽  
High False Negative Rate ◽  
Frozen Section Analysis ◽  
Section Analysis

scholarly journals Evaluation of the Benefit of Routine Intraoperative Frozen Section Analysis of Sentinel Lymph Nodes in Breast Cancer

ISRN Oncology ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
C. M. T. P. Francissen ◽  
R. F. D. van la Parra ◽  
A. H. Mulder ◽  
A. M. Bosch ◽  
W. K. de Roos
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Frozen Section ◽  
False Negative ◽  
False Negative Rate ◽  
Operation Time ◽  
Axillary Lymph ◽  
Negative Rate ◽  
Ablative Surgery ◽  
Negative Findings

Aims. Intraoperative analysis of the sentinel lymph node (SLN) by frozen section (FS) allows for immediate axillary lymph node dissection (ALND) in case of metastatic disease in patients with breast cancer. The aim of this study is to evaluate the benefit of intraoperative FS, with regard to false negative rate (FNR) and influence on operation time. Materials and Methods. Intraoperative analysis of the SLN by FS was performed on 628 patients between January 2005 and October 2009. Patients were retrospectively studied. Results. FS accurately predicted axillary status in 525 patients (83.6%). There were 78 true positive findings (12.4%), of which there are 66 macrometastases (84.6%), 2 false positive findings (0.3%), and 101 false negative findings (16.1%), of which there are 65 micrometastases and isolated tumour cells (64.4%) resulting in an FNR of 56.4%. Additional operation time of a secondary ALND after wide local excision and SLNB is 17 minutes, in case of ablative surgery 35 minutes. The SLN was negative in 449 patients (71.5%), making their scheduled operation time unnecessary. Conclusions. FS was associated with a high false negative rate (FNR) in our population, and the use of telepathology caused an increase in this rate. Only 12.4% of the patients benefited from intraoperative FS, as secondary ALND could be avoided, so FS may be indicated for a selected group of patients.

Sign in / Sign up

Export Citation Format

Share Document