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Comparison of Intra-Operative Depth of Invasion Measurement by Frozen Section with Post-Operative Histopathology in Patient of Oral Cavity Squamous Cell Carcinoma

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Abstract

Depth of Invasion (DOI) is an important and independent predictor for occult metastasis and recurrence. AJCC staging system (8th edition) has incorporated DOI in the staging of oral cancers. It is an essential parameter in deciding elective neck dissection. We hereby conducted a study to determine the accuracy of DOI in the frozen section as compared to the histological section in patients with T1N0 oral squamous cell carcinoma. This study was conducted over a period of 45 months in a tertiary care hospital. 31 patients with diagnosed Oral SCC and with T1N0 were enrolled. The intra-operative frozen section was done DOI was measured as per Cap protocol and compared with the DOI in the histopathological section. Strong correlation was found between DOI measured by frozen section and permanent section (r = 0.998; 95% CI, 0.999–0.997). The paired t test showed a mean difference of 0.0066 mm (95% CI, − 0.0103–0.02346 mm; P = 0.096) between frozen section and permanent section. DOI measured was slightly higher in frozen section however this difference was neither statically nor clinically significant.This study shows the accuracy of frozen specimens in determining tumor DOI in T1N0M0 in oral cavity squamous cell carcinoma. Intraoperative DOI along with other factors may be used to determine the need for END (elective neck dissection) in early-stage oral cavity squamous cell carcinoma and thus avoid a staged operation or over- or under-treatment of the neck.

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References

  1. Kane SV, Gupta M, Kakade AC, D’Cruz A (2006) Depth of invasion is the most significant histological predictor of subclinical cervical lymph node metastasis in early squamous cell carcinomas of the oral cavity. Eur J Surg Oncol 32:795

    Article  CAS  PubMed  Google Scholar 

  2. Ettinger DS, Aisner DL, Wood DE, Akerley W, Bauman J, Chang JY, Chirieac LR, DAmico TA, Dilling TJ, Dobelbower M, Govindan R (2018) NCCN guidelines insights: non–small cell lung cancer, version 52018. J Nat Compr Cancer Netw 1(16):807–21

    Article  Google Scholar 

  3. Kiehl P, Matthies B, Ehrich K et al (1999) Accuracy of frozen section measurements for the determination of breslow tumour thickness in primary malignant melanoma. Histopathology 34:257

    Article  CAS  PubMed  Google Scholar 

  4. Frierson HF Jr, Cooper PH (1986) Prognostic factors in squamous cell carcinoma of the lower lip. Hum Pathol 17:346

    Article  PubMed  Google Scholar 

  5. Edge SB, Byrd DR, Compton CC (eds) (2010) AJCC Cancer staging manual. Springer, New York

    Google Scholar 

  6. Ydiatt WM, Shah JP, Hoffman HT et al (2001) AJCC stage groupings for head and neck cancer: should we look at alternatives? a report of the head and neck sites task force. Head Neck 23:607

    Article  Google Scholar 

  7. Dirven R, Ebrahimi A, Moeckelmann N et al (2017) Tumor thickness versus depth of invasion analysis of the 8th edition American joint Committee on cancer staging for oral cancer. Oral Oncol 74:30

    Article  PubMed  Google Scholar 

  8. International Consortium for Outcome Research (ICOR) in Head and Neck Cancer, Ebrahimi A, Gil Z, Amit M et al. (2014) Primary tumor staging for oral cancer and a proposed modification incorporating a depth of invasion: An international multicenter retrospective study. JAMA Otoloaryngol Head Neck Surg. 140: 1138

  9. Warburton G, Nikitakis NG, Roberson P et al (2007) Histopathological and lymphangiogenic parameters in relation to lymph node metastasis in early stage oral squamous cell carcinoma. J Oral Maxillofac Surg 65:475

    Article  PubMed  Google Scholar 

  10. Melchers LJ, Schuuring E, van Dijk BA et al (2012) Tumour infiltration depth ≥4 mm is an indication for an elective neck dissection in pT1cN0 oral squamous cell carcinoma. Oral Oncol 48:337

    Article  CAS  PubMed  Google Scholar 

  11. D’Cruz AK, Vaish R, Kapre N et al (2015) Elective versus therapeutic neck dissection in node-negative oral cancer. N Engl J Med 373:521

    Article  PubMed  Google Scholar 

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  1. INHS Asvini, Mumbai, Maharashtra, India

    Ritu Mehta, Rashmi Yadav & Munish Malhotra

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  1. Ritu Mehta
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  2. Rashmi Yadav
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  3. Munish Malhotra
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Correspondence to Rashmi Yadav.

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Mehta, R., Yadav, R. & Malhotra, M. Comparison of Intra-Operative Depth of Invasion Measurement by Frozen Section with Post-Operative Histopathology in Patient of Oral Cavity Squamous Cell Carcinoma. Indian J Otolaryngol Head Neck Surg 74 (Suppl 2), 2549–2552 (2022). https://doi.org/10.1007/s12070-020-02272-3

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