Assessing Frozen Section Surgical Margin Status in Oral Squamous Cell Carcinoma

Abstract

BACKGROUND A key technique that is used by the pathologists during intraoperative consultation is frozen section evaluation. It is very important for the surgeons to know if the surgical margin is clear of malignant cells and the status of dysplasia during oncosurgery. There should be concordance between the frozen section margin and paraffin-embedded section. The purpose of the study was to evaluate and validate the accuracy of frozen section surgical margin status in oral squamous cell carcinoma (OSCC) among 2 observers. METHODS A total of 25 histologically diagnosed OSCC cases from April 2018 to April 2019 were included in the study. A total of 122 surgical margin slides (61 frozen sections and paraffin-embedded slides) were retrieved. The interobserver agreement of frozen section margin status with paraffin-embedded was analyzed. RESULTS Interobserver agreement in frozen section margin was 73.80 % with a kappa value of 0.048 (slight) and P-value 0.344. The interobserver agreement for paraffinembedded margin was 93.40 % with a kappa value of 0.572 (moderate) and P-value 0.005. The concordance between frozen and paraffin section by observer 1 was 85.20 % and by observer 2 was 95.10 %. CONCLUSIONS The rate of discordant will get reduced by accurate sampling along with better communication between pathologist and surgeon and at times of uncertainty, a second pathologist’s opinion can be considered for re-evaluating the interpretations. KEY WORDS Frozen Section Margin Status, Interobserver, Paraffin Embedded Margin Status, OSCC