Retrospective Assessment of the Utility of Imaging, Fine-Needle Aspiration Biopsy, and Intraoperative Frozen Section in the Management of Parotid Neoplasms: The Weill Cornell Medical College Experience

Patel, Kaustubh; Scognamiglio, Theresa; Kutler, David I.; Kuhel, William I.; Gromis, Jonathan; Phillips, C. Douglas; Cohen, Marc A.

doi:10.1159/000381678

Cited by 11 publications

(5 citation statements)

References 10 publications

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“…The use of FNAB is an effective, minimally invasive way to obtain a tissue diagnosis. 53,54,122,124,129,167,171,179,182,217 In an SR, FNAB was found to be accurate in distinguishing malignant from benign lesions with an estimated sensitivity of 80% and a specificity of 97%, although across studies, this varied as widely as 57%-86% and 87%-100% for sensitivity and specificity, respectively. [11][12][13] Sources for this variation are multifactorial and include the experience of the cytopathologist and variability within several procedural and technical aspects of FNAB workflow.…”

Section: Resultsmentioning

confidence: 97%

Management of Salivary Gland Malignancy: ASCO Guideline

Geiger

Ismaila

Beadle

et al. 2021

JCO

225

239

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PURPOSE To provide evidence-based recommendations for practicing physicians and other healthcare providers on the management of salivary gland malignancy. METHODS ASCO convened an Expert Panel of medical oncology, surgical oncology, radiation oncology, neuroradiology, pathology, and patient advocacy experts to conduct a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 2000 through 2020. Outcomes of interest included survival, diagnostic accuracy, disease recurrence, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS The literature search identified 293 relevant studies to inform the evidence base for this guideline. Six main clinical questions were addressed, which included subquestions on preoperative evaluations, surgical diagnostic and therapeutic procedures, appropriate radiotherapy techniques, the role of systemic therapy, and follow-up evaluations. RECOMMENDATIONS When possible, evidence-based recommendations were developed to address the diagnosis and appropriate preoperative evaluations for patients with a salivary gland malignancy, therapeutic procedures, and appropriate treatment options in various salivary gland histologies. Additional information is available at www.asco.org/head-neck-cancer-guidelines .

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Section: Resultsmentioning

confidence: 97%

Management of Salivary Gland Malignancy: ASCO Guideline

Geiger

Ismaila

Beadle

et al. 2021

JCO

225

239

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“…Fine needle aspiration biopsy (FNAB) is helpful in differentiating a MTs from a benign tumor. However, it is an invasive examination, and has the risk of facial nerve injury (2). Therefore, noninvasive imaging is very important for differential diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of single-source dual-energy spectral computed tomography in differentiating parotid gland tumors: initial results

Zhao

Luo

et al. 2018

Quant. Imaging Med. Surg.

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“…The purpose of FS is to provide a sufficient answer to a specific question that has an immediate impact on the intraoperative care of the patient [ 8 ]. In the context of parotid gland tumours, the FS primarily aims to determine dignity and, in some cases, to clarify an indeterminate preoperative fine needle aspiration cytology [ 10 ]. For malignant tumours, FS enables stratification between lymphomas and primary parotid gland carcinomas as well as “low-” and “high-grade” subtypes.…”

Section: Discussionmentioning

confidence: 99%

Frozen Section of Parotid Gland Tumours: The Head and Neck Pathologist as a Key Member of the Surgical Team

Mantsopoulos

Bessas

Sievert

et al. 2022

JCM

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Introduction: The aim of this study was to evaluate the impact of subspecialised head and neck versus general surgical pathologists on the reliability of the histopathologic evaluation during intraoperative consultation. Materials and Methods: The medical records of all patients who underwent a parotidectomy with frozen section between 2006 and 2021 were retrospectively evaluated. The frozen section was evaluated for sensitivity, specificity, accuracy, and predictive value. Assessment by two groups of pathologists (subspecialised head and neck versus general surgical pathologists) was compared, and the nature or types of misdiagnoses compared with final diagnoses on paraffin sections were analysed for the two groups. Results: Our study sample was made up of 669 cases. The mean age of patients was 57.7 years (range: 10–94 years). Of these, 490 patients had a benign lesion (73.2%), whereas 179 patients had a malignant lesion (26.8%). Frozen section had an overall accuracy of 97.6%, sensitivity for malignancy was 91.1%, specificity was 100%, PPV was 100%, and the NPV was 96.8%. The exact histologic subtype in the group of malignant tumours was correctly identified in FS in 89.4% of cases. A comparison of head and neck pathologists versus general surgical pathologists revealed a highly statistically significant difference concerning both overall detection of malignancy (p < 0.001) as well as correct identification of the histologic subtype (p < 0.001). Conclusion: Involvement of subspecialised head and neck pathologists in the intraoperative consultation for salivary gland tumours results in a gain of 19.8% more sensitivity, underlining the importance of specialisation in salivary gland pathology for the optimisation of frozen section quality.

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Retrospective Assessment of the Utility of Imaging, Fine-Needle Aspiration Biopsy, and Intraoperative Frozen Section in the Management of Parotid Neoplasms: The Weill Cornell Medical College Experience

Cited by 11 publications

References 10 publications

Management of Salivary Gland Malignancy: ASCO Guideline

Management of Salivary Gland Malignancy: ASCO Guideline

Diagnostic value of single-source dual-energy spectral computed tomography in differentiating parotid gland tumors: initial results

Frozen Section of Parotid Gland Tumours: The Head and Neck Pathologist as a Key Member of the Surgical Team

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