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 The Value of Intraoperative Frozen Section Analysis for Margin Status in Breast Conservation Surgery in a Nontertiary Institution

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Mona P. Tan ◽  
Nadya Y. Sitoh ◽  
Amanda S. Sim
Keyword(s):  
Early Stage ◽  
Frozen Section ◽  
False Negative ◽  
Breast Conservation ◽  
Breast Conservation Surgery ◽  
Intraoperative Frozen Section ◽  
Conservation Treatment ◽  
Breast Conservation Treatment ◽  
Frozen Section Analysis ◽  
Section Analysis

Introduction. Breast conservation treatment (BCT) for early-stage breast malignancies requires negative margins and good cosmesis. Reoperations may be needed to achieve negative margins, which can have an adverse impact on outcomes. This study was performed to evaluate the efficacy of intraoperative frozen section analysis (IFSA) for margin assessment to reduce excision rates.Methods. All patients treated at the authors’ private healthcare facility between 2009 and 2011 for breast cancer were included in the study. Those for whom BCT was intended underwent wide excision with IFSA. Six margins of the excised tissue, and the sentinel lymph node (SLN), where appropriate, were submitted for IFSA. Patient demographics, tumour characteristics, number of operations performed, and outcomes were analysed.Results. Of the 161 patients analysed, 138 (85.7%) had successful breast conservation. Four patients required a reoperation for incomplete surgical extirpation. One had a false negative SLN assessment on IFSA, and was returned to the operating room for an axillary dissection. Three patients required reoperations for inadvertently missed multicentric disease. None had false negative margin evaluation with IFSA necessitating reexcision.Conclusion. The use of IFSA allows low rates of reoperation with BCT. Further research is needed to establish consistency in low reexcision rates for cost-effectiveness and optimum resource allocation.

Presurgical Curettage Improves Accuracy for Nonmelanoma Skin Cancer Excision

2019 ◽  
Vol 23 (6) ◽  
pp. 617-623
Author(s):  
Matthew J. Lin ◽  
Danielle P. Dubin ◽  
Cerrene N. Giordano ◽  
Hooman Khorasani ◽  
David A. Kriegel
Keyword(s):  
Skin Cancer ◽  
Frozen Section ◽  
Normal Skin ◽  
Surgical Margin ◽  
Nonmelanoma Skin Cancer ◽  
Skin Cancers ◽  
Frozen Section Analysis ◽  
Skin Cancer Surgery ◽  
Nonmelanoma Skin Cancers ◽  
Section Analysis

Background Presurgical curettage before nonmelanoma skin cancer surgery may help delineate tumor subclinical extensions. Objective To determine histologically whether presurgical curettage appropriately or inappropriately changes excision specimen size. Materials and Methods One hundred fifty consecutive nonmelanoma skin cancers treated with Mohs micrographic surgery. The clinical margin (CM) was marked. Presurgical curettage was then performed and the resultant presurgical curettage margin (PCM) marked. Frozen section analysis of the CM and PCM revealed whether the curettage-induced margin change was appropriate or unnecessary. Results Presurgical curettage appropriately increased the surgical margin in 9.3% of cases, reducing the number of Mohs stages from 2 to 1. It appropriately decreased the surgical margin in 17.3% thereby conserving normal skin. In 19.4% of cases the curettage increased the margin in situations where the CM had underestimated the size of the tumor; however, in these cases, the curettage did not increase the margin sufficiently to clear the tumor. In 44.0% of cases the PCM did not change the size of the stage I specimen compared to the CM and confirmed the CM. In 10.0% of cases, preoperative curettage reduced margin accuracy by removing healthy tissue (8.0%) or underestimating tumor (2.0%). These errors were associated with eyelid location, severe background photodamage, and morpheiform/infiltrating/sclerosing basal cell carcinomas. Conclusion Presurgical curettage can improve tumor excision accuracy and efficiency. Careful tumor selection is important to optimize curette utility.

Utility of intraoperative frozen section analysis of surgical margins in region of neurovascular bundles at radical prostatectomy

Urology ◽  
2002 ◽  
Vol 59 (5) ◽  
pp. 709-714 ◽  
Author(s):  
Reza Z Goharderakhshan ◽  
Daniel Sudilovsky ◽  
Lauren A Carroll ◽  
Gary D Grossfeld ◽  
Richard Marn ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Frozen Section ◽  
Surgical Margins ◽  
Intraoperative Frozen Section ◽  
Frozen Section Analysis ◽  
Section Analysis ◽  
Neurovascular Bundles

Is intraoperative frozen section analysis an efficient way to reduce positive surgical margins?

Urology ◽  
2005 ◽  
Vol 66 (6) ◽  
pp. 1287-1291 ◽  
Author(s):  
Toshiki Tsuboi ◽  
Makoto Ohori ◽  
Kentaro Kuroiwa ◽  
Victor E. Reuter ◽  
Michael W. Kattan ◽  
...  
Keyword(s):  
Frozen Section ◽  
Surgical Margins ◽  
Positive Surgical Margins ◽  
Intraoperative Frozen Section ◽  
Frozen Section Analysis ◽  
Section Analysis
Sign in / Sign up

Export Citation Format

Share Document