scholarly journals Role of Intraoperative Pathology Consultation in Skeletal Tumors and Tumor-Like Lesions

Sarcoma ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Poonam Bhaker ◽  
Harsh Mohan ◽  
Uma Handa ◽  
Sudhir Kumar
Keyword(s):  
Surgical Procedure ◽  
Bone Tumors ◽  
Resection Margin ◽  
Diagnostic Yield ◽  
Frozen Section ◽  
Imprint Cytology ◽  
Paraffin Sections ◽  
Resection Margin Status ◽  
Tumor Like Lesions

Early and accurate detection of bone tumors and their staging are important since some of them are highly malignant. Intraoperative pathological consultation in bone tumors and tumor-like conditions is quite complex; however, it allows improvement in prognosis and limb salvage. Present study was conducted on 52 patients who underwent surgical procedure after clinical and radiological diagnosis of bone tumors/tumor-like conditions. Fresh unfixed tissue was quickly inspected grossly, followed by preparation of imprint smears and frozen section which were evaluated by two pathologists separately and compared subsequently with reports of paraffin-embedded sections. Clinical reasons for intraoperative consultation were to make diagnosis in 65.4% of cases and to determine resection margin status in 21.1% while in 13.5% of cases, it was for both indications. Diagnostic yield of imprint smears was 87.8% (13 malignant, 22 benign, and 1 tumor-like) and of frozen section was 90.2% (16 malignant, 19 benign, and 2 nonneoplastic) while paraffin sections could diagnose specific tumors in 95.1% (18 malignant, 18 benign, and 3 nonneoplastic). Although frozen section had better sensitivity (88.2%), it had less specificity (94.7%) as compared to imprint smears (76.5% and 100%, resp.). Imprint cytology and frozen section together provide a quick, safe, and reliable intraoperative provisional tissue diagnosis in skeletal tumors and tumor-like conditions.

P96 THE CURRENT ROLE OF ADJUVANT THERAPY IN PATIENTS FOLLOWING NEO-ADJUVANT CHEMOTHERAPY AND R0 RESECTION FOR LOWER OESOPHAGEAL AND GOJ ADENOCARCINOMA

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
R Bott ◽  
J Zylstra ◽  
M Wilkinson ◽  
W Knight ◽  
C Baker ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Adjuvant Therapy ◽  
Adjuvant Treatment ◽  
Survival Benefit ◽  
Resection Margin ◽  
Margin Status ◽  
R0 Resection ◽  
Resection Margin Status ◽  
Neo Adjuvant Chemotherapy

Abstract Aim  The aim of this study was to assess the survival benefit of adjuvant therapy in R0 resection patients following neo-adjuvant chemotherapy and surgery for lower oesophageal and GOJ adenocarcinoma. Background & Methods  The role of adjuvant therapy in oesophago-gastric adenocarcinoma patients treated by neo-adjuvant chemotherapy is contentious. In UK practice surgical resection margin status is often used to stratify patients into receiving adjuvant treatment. Two prospectively collected institutional databases were combined. Patients were classified by the adjuvant therapy received. Crude and adjusted Cox regression analyses compared overall and recurrence free survival according to the adjuvant treatment, stratified by resection margin status. Recurrence patterns were assessed as a secondary outcome. Results  A total of 616 patients were included (373 R0, 243 R1). In hospital mortality following surgery was 1% and these patients were excluded from analysis (n=7). In the R0 resection group 220 patients (59%) had no adjuvant treatment and 137 patients (37%) had adjuvant chemotherapy. On adjusted analysis pathological N status (p<0.0001), poor differentiation (p=0.005) and poor response to neo-adjuvant chemotherapy (p=0.001) were independently associated with poor survival. The benefit of adjuvant chemotherapy did not reach independent significance (HR 0.65 95% CI 0.40-1.06; p=0.087) compared to no treatment. However, it was observed that responders to neo-adjuvant chemotherapy (Mandard 1-3) were more likely to demonstrate a survival benefit from adjuvant chemotherapy (HR 0.42 95%CI 0.15-1.11; p=0.081) than those who are deemed to be non-responders (Mandard 4&5, HR 0.71 95%CI 0.39-1.32; p= 0.280). Conclusion  Adjuvant chemotherapy may have a survival benefit in R0 resection patients following surgery, but this is likely to be limited to patients exhibiting a good response to neo-adjuvant chemotherapy.

scholarly journals The Impact of Intraoperative Frozen Section on Resection Margin Status and Survival of Patients Underwent Pancreatoduodenectomy for Distal Cholangiocarcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Zhiqiang Chen ◽  
Bingran Yu ◽  
Jiaping Bai ◽  
Qiong Li ◽  
Bowen Xu ◽  
...  
Keyword(s):  
Median Survival ◽  
Statistical Difference ◽  
Resection Margin ◽  
Frozen Section ◽  
Margin Status ◽  
R0 Resection ◽  
Distal Cholangiocarcinoma ◽  
Intraoperative Frozen Section ◽  
Resection Margin Status ◽  
The Impact

BackgroundIntraoperative frozen section (FS) is broadly used during pancreaticoduodenectomy (PD) to ensure a negative margin status, but its survival benefits on obtaining a secondary R0 resection for distal cholangiocarcinoma (dCCA) is controversial and unclear.MethodsClinical data of 107 patients who underwent PD for dCCA was retrospectively collected and divided into different groups based on use of FS (FS and non-FS groups) and status of resection margin (pR0, sR0 and R1 groups), and clinical parameters and survival of patients were compared and analyzed accordingly.ResultsThere were 50 patients in FS group with a median survival of 28 months, 57 patients in non-FS group with a median survival of 27 months. There was no statistical difference between the two groups with Kaplan-Meier survival analysis (P = 0.347). There were 98 patients in R0 group (88 in pR0 and 10 in sR0) and nine patients in R1 group, with a median survival of 29 months and 22 months respectively, which showed a better survival in R0 group than in R1 group (P = 0.006). Survival analyses between subgroups revealed difference between pR0 and R1 group (P = 0.005), while no statistical difference concerning pR0 vs. sR0 (P = 0.211) and sR0 vs. R1 groups (P = 0.262). Multivariate Cox regression analysis revealed resection margin status, pre-operative biliary drainage and lymph node invasion to be independent prognostic factors for dCCA patients.ConclusionsIntraoperative FS should be recommended as it significantly increased the rate of R0 resection, which was positively related to a better survival. A primary R0 resection should also be encouraged and if not, a secondary R0 could be considered at the discretion of surgeons as it showed similar survival with primary R0 resection.

Role of intraoperative frozen section for assessing distal resection margin after anterior resection

2015 ◽  
Vol 30 (8) ◽  
pp. 1081-1089 ◽  
Author(s):  
Rachel M. Gomes ◽  
Manish Bhandare ◽  
Ashwin Desouza ◽  
Munita Bal ◽  
Avanish P. Saklani
Keyword(s):  
Anterior Resection ◽  
Resection Margin ◽  
Frozen Section ◽  
Distal Resection Margin ◽  
Intraoperative Frozen Section

scholarly journals Role of imprint cytology and frozen section in the diagnosis of tumours

2018 ◽  
Vol 4 (8) ◽  
pp. 578-585
Author(s):  
Dr. Shubha. H.V. ◽  
◽  
Dr. Arun. H. N. ◽  
Dr. Nirmala. C. ◽  
Dr. Dayananda. S. Biligi ◽  
...  
Keyword(s):  
Frozen Section ◽  
Imprint Cytology

scholarly journals Role of Intraoperative Pathology Consultation by Imprint and Scrape Cytology in Soft Tissue Tumors and Tumor-Like Lesions

Sarcoma ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Rupali Gautam ◽  
Harsh Mohan ◽  
Uma Handa ◽  
Bhumika Bisht
Keyword(s):  
Soft Tissue ◽  
Diagnostic Yield ◽  
Soft Tissue Tumors ◽  
Histopathological Diagnosis ◽  
Cytological Diagnosis ◽  
Therapeutic Decision Making ◽  
Tumor Like Lesions ◽  
Scrape Cytology ◽  
Gross Examination

Intraoperative pathologic consultation plays an essential role in therapeutic decision making, possibly avoiding under or overtreatment of the patient. Common indications for intraoperative consultation include obtaining a diagnosis in an unknown pathology, ruling out malignancy, confirming a provisional diagnosis, and assessing margin status. Fifty patients undergoing surgery for soft tissue tumors or tumor-like lesions were included in the present prospective study to evaluate the role of intraoperative pathologic consultation by imprint and scrape cytology. Careful and quick gross examination of the specimen was performed, followed by processing for imprint and scrape smears. The prepared smears were evaluated by three pathologists and the cytological diagnosis compared subsequently with final histopathological diagnosis. Intraoperative consultation was primarily requested to make or confirm preoperative diagnosis. In 44.0% cases, no previous tissue/cytological diagnosis was available. In 56.0% cases, previous pathological diagnosis was available, but the reports were inconclusive or were reported from outside our institute. The diagnostic yield of imprint smears was 24% (5 malignant, 6 benign, and 1 inconclusive), and scrape smears was 100% (10 malignant, 38 benign, and 2 inconclusive). Paraffin-embedded sections yielded diagnosis in 100% cases (11 malignant, 38 benign, and 1 nonneoplastic). Imprint smears alone were not of much help in intraoperative diagnosis. Scrape smears were found to be superior to imprint smears in terms of diagnostic yield and accuracy. Combined imprint and scrape smear cytology did not provide any advantage in intraoperative provisional tissue diagnosis in soft tissue tumors.

scholarly journals Combined CT guided tru-cut biopsy and imprint cytology in the diagnosis of bone tumors and tumor like lesions

2016 ◽  
Vol 7 (6) ◽  
pp. 40-42
Author(s):  
Moothiringode Chitrabhanu Savithri ◽  
Kanjirakkad Kavitha ◽  
Dominic Puthoor
Keyword(s):  
Bone Tumors ◽  
Bone Lesions ◽  
Imprint Cytology ◽  
Medical Sciences ◽  
Ct Guided ◽  
Primary Bone Tumors ◽  
Definitive Therapy ◽  
Plasma Cell Neoplasms ◽  
Primary Bone ◽  
Tumor Like Lesions

Background: Bone lesions are often histologically  heterogenous. The advantage of tru-cut biopsies in this context is that they provide a safe and accurate biopsy technique that can be performed in less specialized centers.  In this series we found combination of biopsy and cytology helpful in diagnosing bone lesions. However clinical picture and radiologic features are vital in arriving at a final diagnosis.Aims and Objective: 1) To assess the diagnostic accuracy of combined CT guided tru-cut biopsy and imprint cytology  in the diagnosis of bone tumors and tumor like lesions. 2)To analyze the spectrum of different bone lesions.Materials and Methods: 108 consecutive cases of bone lesions for which CT guided  tru-cut biopsy and imprint cytology were done between June 2010 and april 2012 were retrospectively studied. Both smears and biopsies were categorized into five groups.Correlation between biopsy and cytology were also evaluated.Results: Total number of cases were 108 of which 8 cases were inconclusive . In 100 cases a useful opinion could be given. There were 36 cases of primary bone tumors, 13 cases of plasma cell neoplasms, 42 metastatic tumors, 9 non neoplastic lesions and 8 inconclusive cases. Conclusion: Preliminary diagnosis of bone lesions before definitive therapy helps to avoid unnecessary surgical procedures. Tru cut biopsies supplemented by imprint cytology can provide definitive diagnosis in majority of cases.Asian Journal of Medical Sciences Vol.7(6) 2016 40-42

Primary cardiac undifferentiated sarcoma: role of intraoperative imprint cytology and frozen section of two cases

2011 ◽  
Vol 20 (4) ◽  
pp. 232-237 ◽  
Author(s):  
Nesrin Turhan ◽  
Zişan Özgüler ◽  
Kumral Çağlı ◽  
Kerim Çağlı ◽  
Zehra Gölbaşı
Keyword(s):  
Frozen Section ◽  
Imprint Cytology ◽  
Undifferentiated Sarcoma
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