The influence of intraoperative frozen section analysis in patients with total or extended maxillectomy.

Murphy, James; Isaiah, Amal; Wolf, Jeffrey S; Lubek, Joshua E

BACKGROUND Intraoperative frozen sections and final pathology may influence treatment with regards to intraoperative and postoperative treatments, respectively. STUDY DESIGN A retrospective study comparing intraoperative frozen section analysis with final pathologic analysis in patients who had total or extended maxillectomies for malignant disease between 2008 and 2013. RESULTS Twenty-five patients met the inclusion criteria. The mean age was 67.8 years. The majority of patients (76%) had stage IV disease (American Joint Committee on Cancer [AJCC] staging). Intraoperative frozen sections were positive in 24% (n = 6) compared with 60% (n = 15) on final pathologic analysis. Frozen section analysis had a sensitivity of 40%. Positive margins were resected where possible, unless limited by proximity to vital structures. Patients were statistically more likely to follow a recommendation for adjuvant therapy (P < .05) compared with adjuvant chemotherapy (P > .05). CONCLUSIONS Intraoperative frozen section analyses are unreliable in predicting positive margins in patients with late-stage maxillary malignancies. Patients were more likely to accept adjuvant radiation than adjuvant chemotherapy.