The role of frozen section histological analysis in the treatment of head and neck skin basal and squamous cell carcinomas

Background: Skin basal and squamous cell carcinomas together account for over half of all newly diagnosed cancer cases. Frozen section control of surgical margins is often required in the head and neck region. A paraffin permanent section does not always confirm the results of a frozen section. Objectives: To test the diagnostic accuracy of frozen section histopathological analysis in determining the free margins of excised tumors. Methods: This was a retrospective study of 169 cutaneous basal and squamous cell carcinomas excised with surgical margins diagnosed by frozen section and confirmed by permanent paraffin sections. The data included patients age, gender clinical and histopathological diagnosis, as well as characteristics of the lesions. Results: There were 149 (88%) basal cell carcinomas and 20 (12%) squamous cell carcinomas. False negative margins were found in 19 cases (11.2%) and false positive margins in 11 (6.6%). We did not find any correlation between false positive or false negative margins and patients age, gender, tumor size, tumor location, or the presence of sun-damaged skin. A significantly lower rate of false negative results was found in the residual tumor group. Conclusions: Our findings support the use of frozen section margin control in selected patients suffering from non-melanoma skin cancer of the head and neck.