Reliability of frozen section in determining tumor thickness intraoperatively in laryngeal cancer.

ABSTRACT

OBJECTIVES: The relationship between locoregional lymph metastasis and tumor thickness in head and neck cancer has been well documented in recent years. Determining tumor thickness by frozen section may help the surgeon decide intraoperatively whether to perform elective neck dissection, whereas paraffin section results could be obtained at a later time for this decision. The aim of this study was to evaluate the accuracy of tumor thickness measurements obtained by macroscopic measurement and by frozen section intraoperatively in laryngeal cancer. STUDY DESIGN: Prospectively we compared the tumor thickness results obtained by gross visual examination, by frozen section, and by paraffin section in 20 total, near-total, and horizontal supraglottic laryngectomy specimens. METHODS: The sections were stained with hematoxylin and eosin and tumor thickness was measured under a light microscope with an ocular micrometer. RESULTS: A strong correlation was found between frozen section and paraffin section tumor thickness measurements (Pearson correlation coefficient = 0.993, P <.001). Paired t test showed a 4.59 mm mean difference between macroscopic and paraffin section measurements, and a 0.76 mm mean difference between frozen and paraffin section measurements. CONCLUSION: Assessment of tumor thickness in laryngeal cancer intraoperatively by frozen section is a reliable method.