Gokavarapu Sandhya, Chandrasekhara Rao L M, Patnaik Sujit Chau, Parvataneni Nagendra, Raju K V V N, Chander Ravi
Basavatarakam Indo American Cancer Hospital and Research Centre, Hyderabad, 500034 Andhra Pradesh India.
Indian J Otolaryngol Head Neck Surg. 2015 Mar;67(Suppl 1):86-90. doi: 10.1007/s12070-014-0783-6. Epub 2014 Oct 21.
Complex anatomy of oral cavity makes it difficult for a surgeon to assess margins of oral cancer accurately and positive margins compromise loco regional disease control, thus surgeon may rely on frozen section assessment for marginal status. We discussed the prognostic value of frozen section in early carcinoma of oral cavity. 90 patients with pT1 and pT2 oral cavity cancer operated from January 2010 to December 2011 under single consultant surgeon were retrospectively evaluated. Log rank test and multivariate cox regression model was used for testing frozen section against the survival and recurrence free status. Survival of patients with positive or negative frozen section was significant (p = 0.037), Survival of patients with positive or negative histology report was significant (p = 0.004), however; prognosis of patients with positive margins despite revision under frozen control was poorer to the patients with negative margin. Frozen section assessment is accurate but their use in the surgery of oral cavity cancer might not improve loco regional disease control or survival when used routinely.
口腔复杂的解剖结构使得外科医生难以准确评估口腔癌的切缘,而切缘阳性会影响局部区域疾病的控制,因此外科医生可能会依赖冰冻切片评估切缘情况。我们探讨了冰冻切片在口腔早期癌中的预后价值。回顾性评估了2010年1月至2011年12月期间由单一顾问外科医生实施手术的90例pT1和pT2口腔癌患者。采用对数秩检验和多变量Cox回归模型来检验冰冻切片与生存及无复发生存状态的关系。冰冻切片阳性或阴性患者的生存率有显著差异(p = 0.037),组织学报告阳性或阴性患者的生存率也有显著差异(p = 0.004);然而,尽管在冰冻切片控制下进行了修正,切缘阳性患者的预后仍比切缘阴性患者差。冰冻切片评估是准确的,但在口腔癌手术中常规使用时,可能无法改善局部区域疾病的控制或生存率。