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Accuracy of intra-operative frozen section in guiding surgical staging of endometrial cancer

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Surgery consists the main treatment of endometrial cancer; however, decision of lypmhadenectomy is controversial. Intra-operative frozen section (FS) is commonly used in guiding surgical staging; nevertheless, there are different reports regarding its adequacy and reliability. Aim of this study is to assess accuracy of FS in predicting paraffin section (PS) results in patients with endometrium cancer.

Methods

Data of 223 cases, who were operated for endometrial cancer at a tertiary hospital in 2012–2019, were analyzed retrospectively. Histological type, grade, tumor diameter, depth of myometrial invasion, and cervical and adnexal involvement in frozen and paraffin section were evaluated. Positive and negative predictive values and accuracy of frozen results in predicting paraffin results for each parameter was assessed. Statistical significance was taken as 0.05 in all tests.

Results

Accuracy of FS in predicting PS results were 76.23% for histology, 75.45% for grade, 85.31% for depth of myometrial invasion, and 95.45% for tumor diameter. Surgery, based on FS results, caused undertreatment in 4 patients, while metastatic lymph node ratios were found in only 35.3–50.0% of cases who had high risk parameters at FS.

Conclusion

Our FS results have reasonable accuracy rates in predicting PS results, in comparison with the previous literature. However, even if the high risk parameters detected in FS predict PS accurately, absence of lymph node involvement in all cases with high risk parameters indicates that FS-based triage cannot prevent unnecessary lymphadenectomies.

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Acknowledgments

Statystical analyses was provided by Çağla Sarıtürk, Başkent University, Department of Biostatystics.

Funding

This study did not receive any funding.

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Authors and Affiliations

  1. Faculty of Medicine, Department of Gynecology and Obsterics, Başkent University, Adana Application and Research Hospital, Adana, Turkey

    Gülşen Doğan Durdağ, Songül Alemdaroğlu, Şafak Yılmaz Baran, Seda Yüksel Şimşek & Hüsnü Çelik

  2. Faculty of Medicine, Department of Pathology, Başkent University, Adana Application and Research Hospital, Adana, Turkey

    Filiz Aka Bolat

Authors
  1. Gülşen Doğan Durdağ
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  2. Songül Alemdaroğlu
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  5. Seda Yüksel Şimşek
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  6. Hüsnü Çelik
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Contributions

GDD: data collection and manuscript writing. SA: data collection. FAB: data collection. ŞYB: data collection. SYŞ: data collection. HÇ: project development and manuscript editing.

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Correspondence to Gülşen Doğan Durdağ.

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All authors declare that they have no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

Ethical approval

All procedures performed in the study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments. This study was approved by Başkent University Institutional Review Board (No. KA20/128).

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Doğan Durdağ, G., Alemdaroğlu, S., Aka Bolat, F. et al. Accuracy of intra-operative frozen section in guiding surgical staging of endometrial cancer. Arch Gynecol Obstet 304, 725–732 (2021). https://doi.org/10.1007/s00404-021-05979-y

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  • DOI: https://doi.org/10.1007/s00404-021-05979-y

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