title: Intraoperative assessment of surgical margins of oral squamous cell carcinoma using frozen sections: a practical clinicopathological management for recurrences.
abstract: BACKGROUND
  Local recurrence remains a challenging clinical issue for the treatment of oral squamous cell carcinoma (SCC). We analyzed retrospectively how effective the frozen section technique (FS) was against recurrences of oral SCC.
  
  
  METHODS
  We screened 343 surgical samples from 236 patients who had oral SCC, carcinoma in situ (CIS), or epithelial dysplasia, and we followed up their clinical outcomes for at least 5 years. Histopathological states of surgical margins were compared between FS and surgical materials in relapse and relapse-free groups, respectively.
  
  
  RESULTS
  Among the 236 patients, 191 were classified into the relapse-free group, and 45 into the relapse group. FS was more frequently performed in the relapse-free group (128/191) than in the relapse group (83/152). Histopathologically, moderate dysplasia or CIS (borderline malignancies) and SCC were recognized in 55 samples of the relapse-free group and in 57 of the relapse group. For those surgical margins with borderline malignancies, additional incisions were performed in 38 of the 55 relapse-free cases, which reduced to 20 from the 38 margins with borderline malignancies (47.4% reduction), and in 39 of the 57 relapse cases, which reduced to only 3 of 39 (7.7% reduction).
  
  
  CONCLUSIONS
  The intraoperative assessment of surgical margins by FS is essential in preventing recurrences of oral mucosal malignancies.
authors: Division of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8514, Japan ; Department of Dentistry and Oral Surgery, Aizu Chuo Hospital, Aizu Wakamatsu 965-8611, Japan.
authors: Shun
authors: S
authors: Miyota
authors: Division of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8514, Japan.
authors: Takanori
authors: T
authors: Kobayashi
authors: Oral Pathology Section, Department of Surgical Pathology, Niigata University Hospital, Niigata 951-8520, Japan ; Division of Oral Pathology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan.
authors: Tatsuya
authors: T
authors: Abé
authors: Department of Dentistry and Oral Surgery, Aizu Chuo Hospital, Aizu Wakamatsu 965-8611, Japan.
authors: Hisashi
authors: H
authors: Miyajima
authors: Division of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8514, Japan.
authors: Masaki
authors: M
authors: Nagata
authors: Oral Implant Clinic, Niigata University Hospital, Niigata 951-8520, Japan.
authors: Hideyuki
authors: H
authors: Hoshina
authors: Division of Reconstructive Surgery for Oral and Maxillofacial Region, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8514, Japan.
authors: Tadaharu
authors: T
authors: Kobayashi
authors: Division of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8514, Japan.
authors: Ritsuo
authors: R
authors: Takagi
authors: Oral Pathology Section, Department of Surgical Pathology, Niigata University Hospital, Niigata 951-8520, Japan ; Division of Oral Pathology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan.
authors: Takashi
authors: T
authors: Saku
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005629:Frozen Sections; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery*; D011379:Prognosis; D016896:Treatment Outcome; D055815:Young Adult