The Use of Frozen Sections in Buccal Mucosa Squamous Cell Carcinomas.

Abstract

Introduction

Oral squamous cell carcinomas are highly prevalent in India, making them one of the most common types of cancer. The primary approach for treating oral squamous cell carcinomas is surgical excision, with complete surgical resection being the most reliable predictor of successful outcomes. In the final histopathology report, a margin of at least 5mm is considered negative. This study aimed to evaluate the diagnostic accuracy of intraoperative frozen section analysis in assessing tumour bed margins in patients with buccal mucosal squamous cell carcinoma.

Methods

A cross-sectional study was conducted at a tertiary care hospital in Jaipur, India. Between January 2021 and October 2022, a total of 127 patients with pure buccal mucosal squamous cell carcinoma were included in the study, and a total of 482 tumour margins were assessed.

Results

Among the 127 patients with pure buccal mucosa included in the study, 113 (89.0%) were males and 14 (11.0%) were females. The majority of these patients were classified as stage T2 (41; 32.3%) and T4 (44; 34.6%). Lymphovascular invasion was observed in 15 patients (11.8%), and perineural invasion was present in 8 patients (6.3%). Patients with worst patterns invasion 1, 2, 3 were 73 (57.5%) and 4,5 were 54 (42.5%) individuals, respectively. Metastatic lymph nodes were found in 54 (42.5%) of the patients, and 75 (59.1%) had a depth of invasion exceeding 7.50 mm. The frozen section revealed a positive predictive value of 75% and a negative predictive value of 99.3%. In comparison to the permanent section, the sensitivity of the frozen section was 50%, while the specificity was determined to be 99.79%.

Conclusion

The use of frozen section analysis is highly valuable in evaluating tumour margins. Although it demonstrates good diagnostic accuracy, strong clinical correlation is necessary to ensure optimal results.