Understanding frozen section histopathology in sinonasal and anterior skull base malignancy and proposed reporting guidelines Review

  


Authors: Mclean, T.; Fitzgerald, C.; Eagan, A.; Long, S. M.; Cracchiolo, J.; Shah, J.; Patel, S.; Ganly, I.; Dogan, S.; Cohen, M. A.; other members of the study group
Review Title: Understanding frozen section histopathology in sinonasal and anterior skull base malignancy and proposed reporting guidelines
Abstract: Background: Intraoperative frozen section histopathology (IFSH) in sinonasal and skull base surgery although widely used is not well studied. Methods: We reviewed a database of sinonasal and anterior skull base tumors, between 1973 and 2019, and identified 312 suitable operative cases. Clinicopathologic data was collected and analyzed, in addition to descriptive data for histopathological reports classified as “ambiguous,” or “limited/insufficient-quality/quantity.”. Results: Overall, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for IFSH were 90.2%, 97.5%, 94.2%, 95.6%, and 95.2%, respectively. IFSH for adenocarcinoma, salivary carcinoma, and SCC all demonstrated a better clinical utility with a sensitivity of 90% or greater, while it was less than 90% for esthesioneuroblastoma, melanoma, and sarcoma. Other factors such as unclear reporting, poor quality specimens, or limited quality specimens were shown to lower diagnostic performance. Based on limitations identified, we proposed a novel IFSH reporting algorithm to improve IFSH in sinonasal and skull base surgery. Conclusions: IFSH is an accurate and clinically useful technique in sinonasal and skull base surgery patients; however, limitations exist. © 2023 Wiley Periodicals LLC.
Keywords: adenocarcinoma; pathology; head and neck cancer; skull base neoplasms; frozen section; skull base tumor; frozen sections; nose tumor; nose neoplasms; nose cavity; nasal cavity; procedures; intraoperative frozen section; skull base malignancy; humans; human; sinonasal malignancy
Journal Title: Journal of Surgical Oncology
Volume: 128
Issue: 8
ISSN: 0022-4790
Publisher: Wiley Blackwell  
Date Published: 2023-12-15
Start Page: 1243
End Page: 1250
Language: English
DOI: 10.1002/jso.27429
PUBMED: 37650809
PROVIDER: scopus
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85169312386&doi=10.1002%2fjso.27429&partnerID=40&md5=7156681c91ce3755d084d1aa8070ed7d
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in PubMed and PDF -- Corresponding author is MSK author: Marc A. Cohen -- Source: Scopus
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MSK Authors
  1. Snehal G Patel
    412 Patel
  2. Snjezana Dogan
    187 Dogan
  3. Ian Ganly
    430 Ganly
  4. Jatin P Shah
    721 Shah
  5. Jennifer Rose Cracchiolo
    98 Cracchiolo
  6. Marc A Cohen
    130 Cohen
  7. Sallie Long
    6 Long
  8. Conall Fitzgerald
    27 Fitzgerald
  9. Andrew Timothy Mclean
    9 Mclean
  10. Alana Eagan
    23 Eagan
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