Reliability of Frozen Section Pathology in Transoral Laser Laryngectomy

Abstract

Objective: To evaluate the reliability of frozen section analysis in transoral laser laryngectomy (TOLL).Methods: A retrospective analysis was conducted for patients who underwent TOLL in a university hospital between January 2012 and February 2014. The grade of the tumor and the histopathological diagnosis were noted. The results of frozen section pathologies and routine histological examinations were compared.Results: A total number of 84 sections from 21 patients with a mean age of 57.3 years were included in the study. All the patients were operated with superpulse continuous mode carbon dioxide laser with a power of 5-8 watts. Squamous cell carcinoma was histologically diagnosed in all patients. The tumor was grade 1 in 80.95% of the patients, grade 2 in 9.52%, and grade 3 in 9.52%. A routine histopathological examination confirmed the frozen section in 94.04% of the patients. Conclusion:Laser surgery is a commonly preferred treatment modality in early-stage laryngeal carcinomas, in particular. However, a safe surgical margin is a debate in transoral laser surgery. In light of our results, we can conclude that frozen section pathology is a reliable method to achieve safe surgical margins in TOLL. Keywords

Predictive factors of frozen section in transoral microlaryngeal surgery for suspicious glottic lesions

“…The most prominent factors that may be related to an incorrect diagnosis in the frozen biopsy are the presence of mixed pathologies in the same lesion (one portion with dysplasia and another with invasive carcinoma, for example), superficially performed biopsy (with difficulty in determining the invasiveness), and inadequate sample size. 9 , 10 , 17 …”

A Retrospective Study to Assess the Accuracy of Frozen Sections in Laser Laryngeal Surgery

“…The first study was performed by Remacle et al 3 in 2010, wherein he evaluated 97 patients with glottic cancers who underwent a TLMC and reported a consistency rate of 94.8%. The second study done by Ocak et al 4 in 2015 evaluated 84 sections taken from 21 patients who underwent a transoral laser laryngectomy, of which, 13 patients had a lesion in the glottis and 8 in the supraglottis. The author observed a consistency in the results of the FS analysis and PS in 79 of those 84 sections, reporting a reliability rate being 94.04%.…”