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Accuracy of intraoperative consultation in lesions of the salivary glands: analysis of 748 cases

Acurácia da consulta intraoperatória em lesões das glândulas salivares: análise de 748 casos

Introduction:

Lesions of the salivary glands are uncommon, representing 2% to 6.5% of all neoplasms of head and neck, and because of the difference in treatment between them, an accurate diagnosis is essential. The cytological study by fine-needle aspiration (FNA) biopsy is a highly accurate method used to diagnose lesions of the salivary glands. Intraoperative consultation (IOC), in its turn, is a test that provides diagnosis during surgery, aiming to differentiate malignant from benign lesions and to enable the most appropriate surgical approach.

Objective:

To evaluate the accuracy of IOC in salivary gland lesions.

Material and methods:

A survey was conducted in the database of Instituto Nacional de Câncer (Inca) into IOC for diagnosis of salivary gland lesions from January 2001 to December 2012, and found 748 cases. Diagnosis made at IOC (IOCD) was compared with the gold standard histopathological diagnosis and classified into: 1) consenting; 2) discordant; and 3) indeterminate. From these data, sensitivity, specificity and accuracy were calculated.

Results:

Among the 748 IOCs, results were concordant in 656 cases (88%), discordant in 56 (7%), and indeterminate in 36 (5%). Sensitivity was 78%, specificity 99% and accuracy 92%.

Conclusion:

Our results indicate that IOC in salivary gland lesions is highly accurate and can contribute to the surgical approach.

intraoperative consultation; salivary glands; accuracy; neoplasia; pathology


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