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Frozen section versus gross examination for bone marrow margin assessment during sarcoma resection
Megan E Anderson1, Patricia E Miller, Kelsey van Nostrand
1Department of Orthopaedic Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA, Megan.Anderson@childrens.harvard.edu.
Clinical Orthopaedics and Related Research
|April 27, 2013
Summary
Intraoperative frozen section analysis for bone sarcoma margins is often disregarded, with gross specimen inspection guiding surgical decisions. This suggests frozen sections may be omitted to save time and cost.
Area of Science:
- Orthopedic Oncology
- Surgical Pathology
- Diagnostic Imaging
Background:
- Complete resection is crucial for managing primary bone sarcomas.
- Intraoperative frozen section of bone marrow margins is a common practice to assess tumor involvement.
Purpose of the Study:
- To evaluate the correlation between intraoperative frozen section and gross specimen inspection for bone marrow margins.
- To determine how discrepancies impact clinical decisions.
- To assess agreement with final pathology reports.
Main Methods:
- Analysis of 195 bone marrow margins from 142 patients with primary sarcomas.
- Comparison of frozen section interpretation with gross specimen inspection.
- Evaluation of intraoperative decisions based on these assessments.
Main Results:
- Frozen section agreed with gross inspection in 95.6% of negative and 38.5% of positive cases.
- In all 16 disagreements, gross specimen inspection guided surgical decisions, and frozen sections were disregarded.
- Final pathology confirmed negative margins for all patients.
Conclusions:
- Intraoperative frozen section for bone marrow margins is frequently redundant and can be omitted.
- Gross specimen inspection is adequate for achieving negative margins in bone sarcoma surgery.
- Omitting frozen sections can save operative time and reduce costs.
