The influence of intraoperative frozen section analysis in patients with total or extended maxillectomy.
BACKGROUND
Intraoperative frozen sections and final pathology may influence treatment with regards to intraoperative and postoperative treatments, respectively.


METHODS
A retrospective study comparing intraoperative frozen section analysis with final pathologic analysis in patients who had total or extended maxillectomies for malignant disease between 2008 and 2013.


RESULTS
Twenty-five patients met the inclusion criteria. The mean age was 67.8 years. The majority of patients (76%) had stage IV disease (American Joint Committee on Cancer [AJCC] staging). Intraoperative frozen sections were positive in 24% (n = 6) compared with 60% (n = 15) on final pathologic analysis. Frozen section analysis had a sensitivity of 40%. Positive margins were resected where possible, unless limited by proximity to vital structures. Patients were statistically more likely to follow a recommendation for adjuvant therapy (P < .05) compared with adjuvant chemotherapy (P > .05).


CONCLUSIONS
Intraoperative frozen section analyses are unreliable in predicting positive margins in patients with late-stage maxillary malignancies. Patients were more likely to accept adjuvant radiation than adjuvant chemotherapy.
Department of Oral and Maxillofacial Surgery, University of Maryland, Baltimore, MD, USA.
James
J
Murphy
Department of Otolaryngology Head and Neck Surgery, University of Maryland, Baltimore, MD, USA.
Amal
A
Isaiah
Department of Otolaryngology Head and Neck Surgery, University of Maryland, Baltimore, MD, USA.
Jeffrey S
JS
Wolf
Department of Oral and Maxillofacial Surgery, University of Maryland, Baltimore, MD, USA. Electronic address: Jlubek@umaryland.edu.
Joshua E
JE
Lubek
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005629:Frozen Sections; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008437:Maxilla / Q000473:pathology* / Q000601:surgery*; D008441:Maxillary Neoplasms / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies