title: Gross examination by the surgeon as an alternative to frozen section for assessment of adequacy of surgical margin in head and neck squamous cell carcinoma.
abstract: BACKGROUND
  The cost-effectiveness of the frozen section for assessment of margin in head and neck squamous cell carcinoma (HNSCC) is still contentious. The purpose of this study was to evaluate whether gross examination of margin is an alternative to frozen section.
  
  
  METHODS
  It was a prospective observational study in 145 consecutive patients undergoing surgery for HNSCC. Surgical margins were first assessed by the surgeons with a metallic scale. All specimens were then examined using frozen section and permanent section.
  
  
  RESULTS
  Overall, 83% of inadequate margins were detected by frozen section. The chances of inadequate margin were very low if gross surgical margin were 7 mm or more. Gross examination alone (with 7 mm as cutoff) predicted 88% of the inadequate surgical margin. There was no difference in precision of frozen section vis-à-vis gross examination with 7 mm cut off (p ≤ .8).
  
  
  CONCLUSIONS
  Achievement of 7 mm surgical margin measured by a surgeon obviates the need for frozen section.
authors.affiliation: Department of Head and Neck Surgery, Tata Memorial Hospital, Mumbai, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Chaturvedi
authors.forename: Sourav
authors.initials: S
authors.lastname: Datta
authors.forename: Sudhir
authors.initials: S
authors.lastname: Nair
authors.forename: Deepa
authors.initials: D
authors.lastname: Nair
authors.forename: Prashant
authors.initials: P
authors.lastname: Pawar
authors.forename: Sagar
authors.initials: S
authors.lastname: Vaishampayan
authors.forename: Asawari
authors.initials: A
authors.lastname: Patil
authors.forename: Shubhada
authors.initials: S
authors.lastname: Kane
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery*; D005629:Frozen Sections; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D007432:Intraoperative Period; D015588:Observer Variation; D011446:Prospective Studies; D012680:Sensitivity and Specificity
keywords: frozen section; gross assessment; head and neck squamous cell carcinoma; surgical margin