Zainab Sawafta
Queen Elizabeth Hospital, UK
Title: Improved complete excision rates using En Face frozen section margin histology to manage nonmelanoma head and neck skin cancers
Biography
Biography: Zainab Sawafta
Abstract
Introduction: Head and neck cancers are challenging to excise due to their close proximity to vital structures. Non-melanoma skin cancers (NMSC) that are incompletely excised, recurrent or in high risk sites are offered Mohs micrographic surgery (MMS). Access and waiting lists for MMS are variable, impacting upon patient preference for other treatments. Our unit excises these lesions using En Face frozen section margin assessment.
Methods: A retrospective review of all head and neck NMSC excised in our unit using En Face margin frozen section histological examination was performed from 2010 to 2014. The number of excisions required, complete excision rates and recurrences to date were reviewed.
Results: 68 patients were treated using this technique with a total of 69 head and neck cancers excised. 72% of excision margins were clear after primary excision, 25% were clear at second excision. Patients had a mean follow up of 5.6 months (range 1-23) with no recurrences reported to date. 97% of NMSC cases were completely excised with 2 cases incompletely excised.
Conclusion: We have found rates of complete excision of high-risk NMSC’s excised at our unit to be improved by the use of En Face sectioning. Our data shows that approximately 27% of patients had incomplete margins on primary resection using excision margins as per national guidelines, justifying the use of this technique in this group. We suggest that this technique is a safe and useful alternative to MMS in areas where waiting times or geographical area prevent its use.