How Accurate Is Frozen Section for Skin Cancers?

Manstein, Mark Eric; Manstein, Carl H.; Smith, Rosamund C.

doi:10.1097/01.sap.0000069073.38391.91

Cited by 56 publications

(42 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The findings confirm the use of FS evaluation of margin in some patients suffering from SCC and BCC cancers of the head and neck (9,15,16). One study (17), reported the positive predictive value of subareolar FS is 100%, negative predictive value 83%, sensitivity 38%, and specificity 100%.…”

Section: Discussionsupporting

confidence: 72%

A Diagnostic Accuracy Comparison Between Tzanck Smear Test and Frozen Section Examination in Basal Cell Carcinoma

et al. 2017

View full text Add to dashboard Cite

Background: Mohs' micrographic surgery is a suitable treatment and frozen section (FS) examination is the "gold standard" of surgical margins in tumoral skins. This study compared the diagnostic accuracy between the Tzanck smear test (TST) and frozen section (FS) examination for margin control in surgery for basal cell carcinoma (BCC). Methods: Fifty-nine patients with basal cell carcinoma (BCC) were included. The tumor was excised and the Tzanck smear test (TST) was taken for Papanicolaou staining (Pap staining) and reconfirmation of tumoral cells. Then a dermatologist took margins of tumoral mass. TST was taken from the margins and sent to the dermatopathologist for Pap staining. After dying, each marked fragment was sectioned separately with cryostat. Finally, diagnostic accuracy of TST compared with FS examination was analyzed. Results: The sensitivity and specificity of TST for the evaluation of margin were 0.28 and 0.95; whereas positive and negative predictive values were 0.54 and 0.85, respectively. Positive and negative likelihood values were 5.36 and 0.76, respectively. Diagnostic accuracy was 0.82. The kappa coefficient of agreement between the two methods was 0.28 (P < 0.001). Conclusions: Positive likelihood value and specificity of TST for the evaluation of margin were high; therefore, TST can be suitable in the diagnosis of BCC, but due to low sensitivity and kappa coefficient, TST alone cannot be a suitable alternative method compared to the FS examination for margin control in BCC.

show abstract

Section: Discussionsupporting

confidence: 72%

A Diagnostic Accuracy Comparison Between Tzanck Smear Test and Frozen Section Examination in Basal Cell Carcinoma

et al. 2017

View full text Add to dashboard Cite

show abstract

“…There were no positive margins in paraffin block in any of our patients. Some other centers do not rely on the results of frozen section and prefer delayed reconstruction after negative paraffin block [1,16]. However, in those centers patients who presented this diagnostic dilemma had angiosarcoma and melanocytic tumors and were among those receiving radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Can we put a simplified algorithm for reconstruction of large scalp defects following tumor resection?

et al. 2011

View full text Add to dashboard Cite

BackgroundReconstruction of large scalp defects after tumor resection is a challenging problem. We aimed at putting an algorithm for reconstruction of those defects.MethodsForty-two patients with scalp malignancies were enrolled in this study. Tumors were resected to a 1 cm negative margin and defects were reconstructed according to their size and to patient general condition.ResultsNo peri-operative mortality was encountered. Usage of free flaps was superior in cosmoses and function with an acceptable rate of complications.Conclusionfor scalp defects wider than100 cm2, the best tool of reconstruction is free flaps. Pedicled distant flaps are reserved if free flaps are not feasible or failed. Split thickness skin grafts are cosmetically inferior and not suitable for recurrent and irradiated tumours and better reserved for patients who cannot tolerate major operations.

show abstract

“…The frozen section is an optional tool utilized to intra-operatively assess one or more margins of a surgically excised specimen. Its advisability, reliability and effectiveness are as debated as Mohs micrographic surgery with a corresponding equal distribution of supporters and detractors (8)(9)(10)(11)(12)(13)(14).…”

Section: Frozen Section ---------------------------------------------mentioning

confidence: 99%

“…The use of intra-operative frozen section remains controversial in the surgical treatment of non-melanoma skin cancer, being commonly considered an optional tool, the reliability and effectiveness of which remain questionable (8)(9)(10)(11)(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

Study to determine whether intraoperative frozen section biopsy improves surgical treatment of non-melanoma skin cancer

Nicoletti

Brenta

Malovini

et al. 2012

Molecular and Clinical Oncology

View full text Add to dashboard Cite

Abstract. Skin cancers are the most common types of cancer and their incidence has shown an increase of ~4 to 8% per year over the last 40 years. The majority of skin cancers (~97%) are non-melanoma skin cancers, mainly represented by basal cell (80%) and squamous cell carcinomas (20%). The use of intra-operative frozen section remains controversial in the surgical treatment of non-melanoma skin cancer, being commonly considered an optional tool, the reliability and effectiveness of which remain questionable. A large retrospective study was conducted to examine 670 surgical excisions of non-melanoma skin cancers of the head and neck in 481 patients over a period of nine years, between May, 2002 and December, 2011, at the Plastic and Reconstructive Surgery Unit of the University of Pavia, Salvatore Maugeri Research and Care Institute, Pavia, Italy. Results demonstrated the paradoxical ineffectiveness of an intra-operative frozen section biopsy in pursuing higher rates of radical excision in non-melanoma skin cancers. Nevertheless, a more detailed analysis on the use of frozen sections focusing on the various anatomical sites of the body demonstrated a reverse trend in the eyelids and canthi, where a higher success rate (87.50 vs. 69.77%) in the surgical treatment of non-melanoma skin cancers was obtained with the use of an intra-operative frozen section biopsy. Results of the present study suggested that intra-operative frozen section biopsy be routinely used in the surgical treatment of nonmelanoma skin tumors involving the eyelids and canthi.

show abstract

How Accurate Is Frozen Section for Skin Cancers?

Cited by 56 publications

References 3 publications

A Diagnostic Accuracy Comparison Between Tzanck Smear Test and Frozen Section Examination in Basal Cell Carcinoma

A Diagnostic Accuracy Comparison Between Tzanck Smear Test and Frozen Section Examination in Basal Cell Carcinoma

Can we put a simplified algorithm for reconstruction of large scalp defects following tumor resection?

Study to determine whether intraoperative frozen section biopsy improves surgical treatment of non-melanoma skin cancer

Contact Info

Product

Resources

About