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

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.


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.

MeSH terms

  • Age Factors
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / surgery*
  • Disease-Free Survival
  • Early Detection of Cancer
  • Female
  • Frozen Sections / statistics & numerical data*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Mouth Mucosa / pathology
  • Mouth Neoplasms / mortality
  • Mouth Neoplasms / pathology*
  • Mouth Neoplasms / surgery*
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Paraffin Embedding
  • Proportional Hazards Models
  • Treatment Outcome