Interventional pathologist and intraoperative surgical margin evaluation of radical prostatectomy specimens ex-vivo confocal microscopy vs. frozen section evaluation

Dear Editor, We read with interest the contribution by Sofia Asioli et al. on Interventional Pathologists (IPs) and real-time histological evaluation in surgical and outpatient settings based on ex-vivo confocal microscopy (CFM) 1. The authors review clinical applications in various fields, such as neurosurgery, dermatology and breast pathology, with some reference to prostate pathology, showing the benefits of such technology. Our interest in the contribution by Asioli et al. is related to the adoption of CFM coupled with the involvement of IPs in the intraoperative evaluation of surgical margins of fresh radical prostatectomy specimens (RPSs). Prof. B. Rocco and his team 2 introduced us to such a topic. It is called en-face margin evaluation: an entire surface area of the so-called capsule of the RPS is inspected with a CFM vs. the boundary between the prostate parenchyma and the so-called inked capsule at ~ 5 mm intervals in the conventional intraoperative frozen section analysis (IFS) (including the NeuroSAFE technique) 3.