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手术切缘冰冻切片评估对口腔癌患者生存率的影响

Impact of use of frozen section assessment of operative margins on survival in oral cancer.

作者信息

Pathak Kumar Alok, Nason Richard W, Penner Carla, Viallet Norbert R, Sutherland Donna, Kerr Paul D

机构信息

Department of Surgery, University of Manitoba, and Cancer Care Manitoba, 820 Sherbrook Street, Winnipeg, Manitoba, Canada.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Feb;107(2):235-9. doi: 10.1016/j.tripleo.2008.09.028. Epub 2008 Dec 13.

Abstract

OBJECTIVE

This study looked at the independent impact of intraoperative frozen section assessment of the adequacy of margins of excision on disease control and survival.

STUDY DESIGN

The design was a review of outcome of historical cohort of 416 surgically treated oral cancer patients at a comprehensive cancer center. Status of the margins at permanent sections, disease failure at the primary site, and survival data of 229 patients who had frozen sections were compared by univariate and multivariate analysis with 197 patients who did not have frozen sections.

RESULTS

Failure at the primary site was independently influenced by age at diagnosis (P < .001), T stage (P = .016), N stage (P = .042), and status of margins on paraffin sections (P = .005). Chance of achieving clear margins on paraffin sections was, however, not significantly improved by the use of frozen sections. On multivariate analysis, the use of frozen sections did not independently have an impact on local failure or survival.

CONCLUSIONS

Frozen section assessment of mucosal margins has not improved the disease outcome.

摘要

目的

本研究探讨术中冰冻切片评估切除边缘的充分性对疾病控制和生存的独立影响。

研究设计

该研究是对一家综合癌症中心416例接受手术治疗的口腔癌患者的历史队列结局进行回顾。通过单因素和多因素分析,比较了229例接受冰冻切片检查患者的永久切片边缘状态、原发部位疾病失败情况及生存数据与197例未接受冰冻切片检查患者的情况。

结果

原发部位失败独立受诊断时年龄(P <.001)、T分期(P =.016)、N分期(P =.042)及石蜡切片边缘状态(P =.005)影响。然而,使用冰冻切片并未显著提高石蜡切片切缘阴性的几率。多因素分析显示,使用冰冻切片对局部失败或生存无独立影响。

结论

黏膜边缘的冰冻切片评估未改善疾病结局。

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