Δευτέρα 12 Δεκεμβρίου 2016

Effect of formalin fixation on surgical margins in patients with Oral Squamous Cell Carcinoma

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Publication date: Available online 12 December 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Tejashree B. Pangare, Pushkar P. Waknis, Shilpa S. Bawane, Mayank N. Patil, Shaliki Wadhera, Padmasree B. Patowary
PurposeFormalin fixation causes shrinkage of the surgical margins which may result in underestimation of tumor free margins. The purpose of this study is to demonstrate the effect of formalin fixation on the surgical margins. The aim of this study is to evaluate the surgical margin shrinkage after fixation of specimens of patients with oral squamous cell carcinoma (OSCC) of the gingivobuccal sulcus (GBS).Materials and MethodsThis study was a cross sectional study. The source of the study sample comprised of specimens of OSCC of GBS in which composite resection was carried out. The primary predictable variable was designated as the length of the linear margin at various locations (Anterior, Posterior, Medial and Lateral). The primary outcome variable was designated as the percentage change in each respective margin (Anterior, Posterior, Medial and Lateral ) after fixation in 10% formalin for a period of 24 hours. Other variables were age, gender, smokeless tobacco, smoking status and tumor staging. The difference between pre-fixation and post-fixation data was calculated using paired 't' test.ResultsThe sample comprised of 15 patients, out of which 7 patients were male and 8 were female with age ranging from 55-65 years diagnosed as OSCC of GBS. Shrinkage of surgical margins (drop) occurred after fixation as compared to the margins before fixation. The average surgical margin shrinkage was 18.7%, anterior, 14.9%, posterior, 23.6%, medial and 23.9%, lateral aspects. This shrinkage was statistically significant (P-value <0.001).ConclusionFormalin causes significant shrinkage of the surgical margins. This phenomenon should be considered by the pathologist before giving the final histopathology report.



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