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Interest in frozen section examination of margins and lymph nodes in laryngeal surgery

Published online by Cambridge University Press:  29 June 2007

M. Remacle ,
M. Hamoir ,
E. Marbaix ,
N. Deggouj  and
Y. Frederickx
M. Remacle*
Affiliation:
Department for ENT and Head and Neck Surgery, (Professor J. Van den Eeckhaut).
M. Hamoir
Affiliation:
Department for ENT and Head and Neck Surgery, (Professor J. Van den Eeckhaut).
E. Marbaix
Affiliation:
Department of Anatomo-Pathology, (Professor Cl. Fievez).
N. Deggouj
Affiliation:
Department for ENT and Head and Neck Surgery, (Professor J. Van den Eeckhaut).
Y. Frederickx
Affiliation:
Department for ENT and Head and Neck Surgery, (Professor J. Van den Eeckhaut).
*
Department for ENT and Head and Neck Surgery, University Hospital of Mont-Godinne, Avenue Therasse, 1 B-5180 YVOIR (Belgium).
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Abstract

One hundred and one patients presenting with a squamous cell carcinoma of the larynx underwent surgery i n our department between January 1980 and May 1985. In most of these patients, nodes were removed from the main lymphatic drainage pathways and subjected to immediate frozen section examination. The results from frozen section examination of the nodes were then compared with those from the surgical specimens of cervical neck dissections performed on the patients according to the classic rules. In addition, margin resections were made and examined by frozen section after removal of the tumour. In the event of a positive finding, these resections were continued until healthy tissue was reached, the specimens being examined in addition by classic methods.

Immediate frozen sections enable the margins of the resection to be verified correctly. In our series we were brought to extend the limits of resection in 10 cases out of 68 (15 per cent). It can also be seen that the accuracy of the pathologist's reading of the frozen sections is satisfactory. The overal level of error is three out of 68 (4.5 per cent). All the errors correspond to false negatives.

The aim of avoiding neck dissections in the presence of N0, thanks to nodal selection with frozen section, is not attained. We find a 6/61 rate of false negatives for N0 - N1 (10 per cent) when we compare the frozen sections of the selected nodes and the neck dissections. This is due to the fact that the surgeon may be led astray by a reactive hyperplastic node whilst other less inflammatory neighbouring nodes are in fact the site of metastasis.

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 102 , Issue 9 , September 1988 , pp. 818 - 821
Copyright
Copyright © JLO (1984) Limited 1988

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References

Bocca, E. and Pignataro, O. (1967) A conservation technique in radical neck dissection. Annals of Otology, Rhinology and Laryngology, 76: 975–988.CrossRefGoogle ScholarPubMed
Dankwa, E. K. and Mavies, J. D. (1985) Frozen section diagnosis: an audit. Journal of Clinical Pathology, 38: 1235–1240.CrossRefGoogle ScholarPubMed
Guerrier, Y. and Guerrier, B. (1980) In Traité de technique chi-rurgicale O.R.L. et chirurgie cervico-faciale. Tome IV. Cou et cavité buccale (Guerrier, Y. ed.) pp. 57–123. Masson, Paris.Google Scholar
Grannick, K. J. (1985) Accuracy of frozen section diagnosis in salivary gland lesions. Head and Neck Surgery, 7: 465–467.CrossRefGoogle Scholar
Harrisson, E. G. and Woolnek, L. B. (1963) Fresh frozen section n i head and neck surgery. Surgical Clinics of North America, 43: 943–950.CrossRefGoogle Scholar
Hillel, A. D. and Fee, N. E. (1983) Evaluation of frozen section in parotid gland surgery. Archives of Otolaryngology, 109:203–233.Google ScholarPubMed
Holaday, W. J. and Assor, P. (1974) Ten thousand consecutive frozen sections. American Journal of Clinical Pathology, 61:769–777.CrossRefGoogle ScholarPubMed
Lessels, A. M. and Simpson, J. G. (1976) A retrospective analysis of the accuracy of immediate frozen section diagnosis in surgical pathology. British Journal of Surgery, 63: 327–329.CrossRefGoogle Scholar
Miller, R. H., Calcaterra, T. C. and Paglia, M. E. (1979) Accuracy of frozen section diagnosis of parotid lesions. Annals of Otology, Rhinology and Laryngology, 88: 573–576.CrossRefGoogle ScholarPubMed
Nakazawa, H., Rosen, P., Lane, N., and Lattes, R. (1968) Frozen section experience on 3,000 cases. American Journal of Clinical Pathology, 49:41–51.CrossRefGoogle Scholar
Pinel, J., Cachin, Y., Lacourreye, H., Piquet, J. J., Richard, J. M., Cannoni, M., Trotoux, J., Junien-Lavillauroy, C, Eschwege, F. and Luboinski, B. (1980). Cancers du larynx. Rapport à la Société Française d'oto-rhino-laryngologie et de pathologie cer-vico-faciale. Librairie Arnette Ed. Paris, 127–131.Google Scholar
Remsen, K. A., Lucente, F. E., and Biller, H. F. (1984) Reliability of frozen section diagnosis in head and neck neoplasms. Laryngoscope, 94: 519–525.CrossRefGoogle ScholarPubMed
Saltzstein, S. L. and Nahum, A. M. (1973) Frozen section diagnosis: accuracy and errors: uses and abuses. Laryngoscope, 83: 1128–1143.CrossRefGoogle Scholar
Strong, E. W. (1985) Management of the No neck. In Head and Neck cancer. Volume 1 (Chretien, P. B., Johns, K. E., Shado, D. P., Strong, E. W., Ward, P. eds.) pp. 143–151., B. C. Becker. Mosby Ltd. Philadelphia, Saint-Louis.Google Scholar
Wheelis, R. F. and Yarington, T. (1984) Tumor of the salivary glands. Archives of Otolaryngology, 110: 76–77.CrossRefGoogle ScholarPubMed
Winship, T. and Rosvoll, R. (1959) Frozen sections. An evaluation of 1810 cases. Surgery, 45: 462–466.Google Scholar