Frozen section in thyroid gland follicular neoplasms: It’s high time to abandon it!

Sanabria A, Zafereo M, Thompson LDR, Hernandez-Prera JC, Kowalski LP, Nixon IJ, Shaha A, Rodrigo JP, Mäkitie A, Vander Poorten V, Suarez C, Zbären P, Rinaldo A, Ferlito A
Surg Oncol. 2021 Mar;36:76-81. doi: 10.1016/j.suronc.2020.12.005. Epub 2020 Dec 8.
Thyroid nodules are a very common clinical condition. The 2015 American Thyroid Association (ATA) guidelines recommend surgical excision for Bethesda IV nodules. The use of intraoperative frozen section (FS) has been recommended as a strategy to tailor the extent of the initial surgery. We critically evaluated the literature that discusses the utility and cost-effectiveness of FS to make an intraoperative decision in patients with thyroid nodules classified as follicular neoplasm. FS should not be recommended as a routine intraoperative test to assess for malignancy in thyroid follicular patterned lesions due to its low performance; the high number of deferred results; the inability to adequately assess histologically defining features; the improvements in risk stratification guiding total thyroidectomy; and the low cost-effectiveness of FS.
PubMed ID: 33316682
Article Size: 4.5 MB