A systematic review and meta-analysis of the diagnostic accuracy of frozen section for parotid gland lesions.

@article{Schmidt2011ASR,
  title={A systematic review and meta-analysis of the diagnostic accuracy of frozen section for parotid gland lesions.},
  author={Robert L. Schmidt and Jason Patrick Hunt and Brian J. Hall and Andrew R Wilson and Lester J. Layfield},
  journal={American journal of clinical pathology},
  year={2011},
  volume={136 5},
  pages={
          729-38
        }
}
We conducted a systematic literature review using MEDLINE and Embase to identify articles on diagnostic accuracy of frozen section (FS) for salivary gland lesions published between January 1, 1985, and December 31, 2010. We also reviewed the reference lists of all identified articles and conducted a forward search using Scopus to identify all articles citing the reference set. Meta-analysis was used to produce a summary receiver operating characteristic (SROC) curve from which summary estimates… 
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68 Citations
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Methods Citations
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Results Citations
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68 Citations

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Citation Type

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TLDR
It is concluded that core needle biopsy of salivary gland lesions is more accurate than fine-needle aspiration, at least in some settings, but the best selection of which test to use for an individual patient and setting remains to be defined.
Biopsy of parotid masses: Review of current techniques.
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The current evidence suggests USCB has superior diagnostic potential and is safe, and with time, USCB is likely to supplant FNAC as the biopsy technique of choice, replicating that which has occurred already in other areas of medicine such a breast practice.
Diagnostic accuracy of CBCT for tooth fractures: a meta-analysis.
The role of frozen section biopsy for submandibular gland tumors
TLDR
FSB may be useful for malignancy detection as a final histological diagnosis in cases that are diagnosed as benign or indeterminate by FNAC in SGTs.
Fine needle aspiration cytology for parotid neoplasms: risk of malignancy through inconclusive results and lower grade tumors
TLDR
FNAC is an important tool for preoperative assessment of parotid masses, though its sensitivity in detecting malignancy remains poor and “inconclusive” FNAC results could further jeopardize FNAC accuracy.
Diagnostic Accuracy of Fine-Needle Aspiration for Parotid and Submandibular Gland Lesions
TLDR
FNA has high accuracy in identifying malignancy in parotid and submandibular gland lesions when performed at a high-volume center and is useful in counseling patients for a complete informed consent, according to otolaryngologists.
Frozen section pathology for decision making in parotid surgery.
TLDR
Frozen section pathology for parotid lesions has high accuracy and utility in intraoperative decision making, facilitating timely complete procedures.
Fine needle aspiration cytology and frozen section in the
TLDR
FNAC is an important examination that provides valuable information for the preoperative diagnostic work-up and alerts the surgeon to the possible presence of malignancy, but FNAC cannot be used alone, and FS has a very important place in the intraoperative management of parotid tumours.
Fine needle aspiration cytology and frozen section in the diagnosis of malignant parotid tumours.
Is there a Role for Frozen Section Evaluation of Parotid Masses After Preoperative Cytology or Biopsy Diagnosis?
TLDR
The addition of FS to FNA was helpful to further refine the diagnoses of parotid gland lesions, which may provide better guidance for surgical intervention.
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References

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TLDR
It is not possible to provide a general guideline on the clinical usefulness of FNAC for parotid gland lesions owing to the variability in study results, and there is a need to improve the quality of reporting and study designs to remove or assess the impact of bias.
Evaluation of frozen section diagnosis in 721 parotid gland lesions
TLDR
The reliability of FS diagnosis in comparison with FD is demonstrated, the difficulties encountered by the pathologist are pointed out and the preoperative diagnosis of parotid tumours is debated.
Fine-needle aspiration biopsy of parotid lesions: comparison with frozen section.
TLDR
The present study reflects the experience gained over a 12-year period and shows the accuracy of a diagnostic FNAB, and improved results with experience, as an accurate and useful tool in the management of parotid lesions.
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TLDR
It is concluded that diagnoses of most parotid gland tumors based on frozen section examination are reliable and accurate, but caution should be exercised in malignant tumors diagnosis.
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TLDR
Although there was a significant level of diagnostic disagreement, the clinically significant error rate of 0.08% is significantly lower than previously published error rates and highlights the substantial potential for bias in nonblinded reviews.
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TLDR
Frozen section examination for salivary gland tumors is not sufficient on its own for deciding on the best management and must be correlated with clinical and intraoperative findings, in association with the surgeon's experience.
Relative accuracy of fine‐needle aspiration and frozen section in the diagnosis of lesions of the parotid gland
TLDR
The relative accuracies of both FNA and FS in the diagnosis of salivary gland lesions are determined.
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TLDR
This study confirms that in MEC, tumor grade, subdividing cases into low and high grade by using the criteria delineated by Auclair and Goode, correlates well with prognosis.
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