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Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way
Published on: May 10, 2021
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Is intraoperative margin sampling necessary in inverted papilloma resection?
Eran Glikson1,2, Alberto Dragonetti3, Ethan Soudry4,5
1Department of Otolaryngology Head and Neck Surgery, The Sheba Medical Center, Tel Hashomer, Israel. Eran.Glikson@sheba.health.gov.il.
Summary
Routine intraoperative margin sampling during inverted papilloma (IP) surgery does not impact recurrence rates. However, extending surgery based on positive frozen sections was linked to higher recurrence, questioning the routine use of this technique.
Area of Science:
- Otolaryngology
- Surgical Pathology
Background:
- Inverted papilloma (IP) is a benign neoplasm of the sinonasal tract with a significant recurrence rate.
- Intraoperative margin assessment aims to ensure complete tumor resection and minimize recurrence.
Purpose of the Study:
- To investigate the association between intraoperative frozen section margin sampling and recurrence rates following inverted papilloma resection.
Main Methods:
- A multicenter retrospective study analyzed 220 patients undergoing attachment-oriented IP resection.
- Follow-up was a minimum of 36 months, with a mean of 49 months.
Main Results:
- Overall recurrence rate was 10.45%.
- No significant difference in recurrence was observed between groups with and without intraoperative margin sampling (p=0.44).
- However, cases with extended surgery due to positive frozen sections showed a significantly higher recurrence rate (OR=6.94).
Conclusions:
- Intraoperative margin sampling via frozen section does not appear to influence the recurrence of inverted papilloma.
- The routine utilization of intraoperative margin sampling in IP surgery warrants re-evaluation.
