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Frozen section pathology in IPMN: A systematic review.
Michael J Kirsch1, Salvador Rodriguez Franco2, Toshitaka Sugawara2
1Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Journal of Hepato-Biliary-Pancreatic Sciences
|April 4, 2025
Summary
Intraductal papillary mucinous neoplasms (IPMNs) frozen section pathology accurately predicts final results. However, recurrence occurs even with negative margins, necessitating ongoing surveillance.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Oncology
Background:
- Intraductal papillary mucinous neoplasms (IPMNs) require precise surgical resection.
- Intraoperative frozen section (IFS) pathology is used to assess resection margins.
- The reliability of IFS for IPMNs and its impact on recurrence are critical.
Purpose of the Study:
- To evaluate the concordance between IFS and permanent histopathology for IPMNs.
- To determine the association between IFS margin status and tumor recurrence.
- To assess the clinical utility of IFS in guiding IPMN resection.
Main Methods:
- Systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
- Searched major databases (PubMed, Embase, Scopus, Google Scholar) for relevant studies.
- Extracted data on IFS margin status, final pathology, and recurrence rates from included studies.
Main Results:
- Seven studies comprising 706 patients met the inclusion criteria.
- A high concordance (98%) was observed between IFS and final pathology.
- Positive IFS margins were identified in 9.4% of cases.
- Tumor recurrence was observed in 15.4% of patients, with a significant proportion having negative IFS margins.
Conclusions:
- Intraoperative frozen section (IFS) pathology demonstrates high accuracy in assessing resection margins for IPMNs.
- IFS is a valuable tool for intraoperative decision-making during IPMN resection.
- Despite negative margins, recurrence is possible, underscoring the need for vigilant post-resection surveillance and potentially adjunct diagnostic methods.
