Use of Intraoperative Frozen Section in the Surgical Management of Patients with Nonmelanoma Skin Cancer

Abstract

Background. Intraoperative frozen section (IFS) is often utilised in the surgical treatment of nonmelanocytic skin cancer (NMSC) in sensitive facial regions when Mohs micrographic surgery (MMS) is not available. Objective. To compare the outcome of NMSC patients with excision performed with and without IFS. Materials and Methods. A retrospective, single-centre study was performed on all patients who had undergone resection of NMSC with and without IFS control at the National University Hospital (NUH) from 2010 to 2015. Results. 116 patients were recruited, of which 86 had IFS and 30 did not. The complete excision rate of patients with IFS was higher at 87.2% ( p = 0.0194 ), need for secondary operation was lower at 1.2% ( p = 0.005 ), and need for postsurgery radiotherapy or chemotherapy was lower at 1.2% ( p = 0.001 ). The average duration of surgery in patients who underwent IFS was 95.4 minutes compared to 70.1 minutes in cases which did not undergo IFS. Conclusion. Our study showed an increased complete excision rate and reduced need for secondary surgeries and adjuvant therapy in patients with IFS. However, a longer operative duration was required. Use of IFS may be useful in patients with NMSC lesions in sensitive regions requiring complex reconstruction after tumour excision.

Thumb-Sparing Surgery for Digital Papillary Adenocarcinoma: A Case Report

“…In the case of DPA, intraoperative frozen sections may be used to verify negative margins [ 12 ], but ultimately permanent resection is a more accurate method of histopathological analysis. Although data on the use of frozen sections in DPA is scarce, a study showed that using intraoperative frozen sections (IFS) during nonmelanoma skin cancer resection led to a higher complete excision rate compared to cases without the use of IFS [ 13 ]. The rate of complete excision with IFS was 87.2%, which significantly decreased the need for additional surgeries and adjuvant therapies [ 13 ].…”

Combination of Mustardé cheek advancement flap and paramedian forehead flap as a functional and aesthetic alternative

“…For primary well-demarcated BCCs smaller than 2 cm, in the low-risk group, 3 mm gives satisfactory results. Whereas, in the high-risk group, and for lesions larger than 2 cm, a 4–6 mm margin is suggested for getting clear margins [ 9 ].…”

“…The face is the site most affected by BCC, and after the surgical resection, an ideal facial reconstruction must provide functionality and an appropriate cosmetic appearance. Combining a local and an advancement flap can be further done to achieve this goal [ 9 ]. Reconstruction of our patient used a combination of the paramedian forehead flap, developed by Sushruta Samita in ancient India.…”

A clinical Raman spectroscopy imaging system and safety requirements for in situ intraoperative tissue characterization

“…1,2 On the other hand, pathology analysis of frozen sections is commonly used but they require on average 20 minutes, which can limit the frequency of their use during a procedure. 3,4 Failing to locate and completely remove tumours often result in follow-up repeat surgery from disease recurrence with concomitant negative impact on patient outcomes.…”