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Frozen Section Liver — SCE Medical Oncology MCQ

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ModerateGI CancersFrozen Section LiverSCE Medical Oncology

A 55-year-old man with colorectal cancer undergoes liver surgery. The surgeon sends a specimen for frozen section of the liver resection margin. Why is intraoperative frozen section important in liver surgery for CRC metastases?

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Correct answer: D — Frozen section of the liver parenchymal margin assesses margin adequacy intraoperatively — a positive margin (R1) at the planned transection line allows the surgeon to extend the resection if technically feasible, converting R1 to R0 and improving outcomes

Intraoperative frozen section of the hepatic parenchymal transection margin during liver resection for CRC metastases provides real-time margin assessment. R0 (negative margin) is the strongest prognostic factor for DFS after liver resection. If frozen section shows tumour at the margin (R1), the surgeon can extend the resection to achieve R0 if anatomically feasible. While the optimal margin width is debated (1 mm vs 1 cm), any R0 margin is superior to R1. Frozen section enables this critical intraoperative decision.

Reference: ESMO 2024 mCRC Guidelines; NICE NG151; de Haas et al Ann Surg 2008