Impact of Formalin Fixation on Oral Cancer Surgery Results
Author Information
Author(s): Adam Michcik, Maksym Jopek, Rafał Pęksa, Piotr Choma, Łukasz Garbacewicz, Adam Polcyn, Barbara Wojciechowska, Tomasz Wach, Maciej Sikora, Paolo Iacoviello, Giovanni Audino, Barbara Drogoszewska, Arkadiusz Dziedzic, Robert Kubina
Primary Institution: Medical University of Gdansk
Hypothesis
How does formalin fixation affect the macroscopic resection margins in oral squamous cell carcinoma?
Conclusion
Formalin fixation significantly shrinks the macroscopic resection margins of oral squamous cell carcinoma, particularly in tongue cancers, leading to potential underestimation of safe margins.
Supporting Evidence
- Formalin fixation caused a significant reduction in macroscopic resection margins.
- The greatest shrinkage was observed in tongue cancers, with a median reduction of 1.5 mm.
- Formalin fixation led to 58.5% of previously safe margins being reduced to unsafe levels.
- Overall, the average shrinkage for all specimens was 2.57 mm.
- Minimal changes were observed in the tumors themselves, with an average shrinkage of 0.69 mm.
Takeaway
When doctors remove cancer from the mouth, the way they prepare the samples can make them look smaller than they really are, especially for tongue cancers.
Methodology
The study involved 42 patients with OSCC, using 3D imaging techniques to measure macroscopic resection margins before and after formalin fixation.
Potential Biases
Potential bias in measurement due to subjective assessment of tumor boundaries.
Limitations
The study only included patients with clear tumor boundaries and did not assess tumors without obvious ulceration.
Participant Demographics
{"gender":{"male":30,"female":12},"age":{"50s":6,"60s":16,"70s":12,"80s":8}}
Statistical Information
P-Value
5.06 × 10−76
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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