Intraoperative Assessment of Margin Accuracy in Early Oral Squamous Cell Carcinoma (cT1, T2, N0): Clinical Versus Frozen Section Analysis

Background The incidence of oral cavity cancer is increasing. During oral carcinoma surgery, to achieve a tumor-free margin, intraoperative margin assessment includes two primary methods, namely, clinical examination and frozen section analysis. With extensive preoperative imaging investigations and intraoperative clinical margin assessment, the need for further cost and resource-intensive frozen section analysis has recently come under question. This study aimed to assess whether frozen section analysis can be safely omitted in most cases of early oral squamous cell carcinoma surgeries for cost-effectiveness. Methodology A hospital-based, observational study including 30 admitted cases of early oral squamous cell carcinoma was conducted at the Department of General Surgery, Pradyumna Bal Memorial Hospital, Bhubaneswar. All consecutive confirmed cases of early oral squamous cell carcinoma of all age groups and both genders after considering the inclusion and exclusion criteria were involved in the study. A comparative assessment of the free margins after tumor excision was done by the surgeon followed by frozen section analysis. Results The mean age was 53.03 ± 13.72 years, with a male-to-female ratio of 6.5:1. Carcinoma of the lower alveolus with gingivobuccal sulcus was the most common presentation of the study (33.33%). In our study, clinically assessed margins had a sensitivity of 75.39%, a specificity of 94.43%, and an accuracy of 92.77%. Frozen section assessed margins had a sensitivity of 66.5%, a specificity of 96.94%, and an accuracy of 92.77%. Conclusions Based on the accuracy of clinically assessed and frozen section assessed margins, this study concluded that surgically resected/excised specimen by the surgeon plays a vital role in assessing the adequacy of resected/excised margins in early oral squamous cell carcinoma (cT1, T2, N0) cases, which can possibly replace the costly frozen section analysis.