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Intraoperative evaluation of myometrial invasion and histological type and grade in endometrial cancer: diagnostic value of frozen section

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

Abstract

Purpose

We have conducted a retrospective, comparative analysis of the accuracy of preoperative diagnosis and frozen section diagnosis relative to postoperative diagnosis.

Methods

Subjects consisted of 168 patients with endometrial cancer, and frozen section was also performed. The diagnostic accuracy and the under-diagnosis rates in regard to both the myometrial invasion (MI) and the histological type and grade (HTG) were determined.

Results

The diagnostic accuracy rate for preoperative HTG and MI were 64.3 and 54.8%, while the under-diagnosis rate was 25.0 and 35.7%. In contrast, the corresponding diagnostic accuracy rate for frozen HTG and MI were 84.5 and 85.7%, while under-diagnosis was 9.5 and 9.5%. Statistical analysis showed that the diagnostic accuracy rate for HTG and MI were significantly higher with frozen section diagnosis than with preoperative diagnosis (P < 0.0001) and the under-diagnosis rate for HTG and MI were significantly lower with frozen section diagnosis than with preoperative diagnosis (P < 0.0001).

Conclusions

Frozen section diagnosis was clearly more effective than preoperative diagnosis involving MRI as a basis for deciding the operative technique for endometrial cancer.

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References

  1. Creasman WT, Morrow CP, Bundy BN, Homesley HD, Graham JE, Heller PB (1987) Surgical pathologic spread patterns of endometrial cancer. A Gynecologic Oncology Group Study. Cancer 60:2035–2041

    Article  CAS  PubMed  Google Scholar 

  2. Obermair A, Geramou M, Gucer F, Denison U, Graf AH, Kapshammer E, Medl M, Rosen A, Wierrani F, Neunteufel W, Frech I, Speiser P, Kainz C, Breitenecker G (1999) Endometrial cancer: accuracy of the finding of a well differentiated tumor at dilatation and curettage compared to the findings at subsequent hysterectomy. Int J Gynecol Cancer 9:383–386

    Article  PubMed  Google Scholar 

  3. Kinkel K, Kaji Y, Yu KK, Segal MR, Lu Y, Powell CB, Hricak H (1999) Radiologic staging in patients with endometrial cancer: a meta-analysis. Radiology 212:711–718

    CAS  PubMed  Google Scholar 

  4. Altintas A, Cosar E, Vardar MA, Demir C, Tuncer I (1999) Intraoperative assessment of depth of myometrial invasion in endometrial carcinoma. Eur J Gynaecol Oncol 20:329–331

    CAS  PubMed  Google Scholar 

  5. Vorgias G, Hintipas E, Katsoulis M, Kalinoglou N, Dertimas B, Akrivos T (2002) Intraoperative gross examination of myometrial invasion and cervical infiltration in patients with endometrial cancer: decision-making accuracy. Gynecol Oncol 85:483–486

    Article  PubMed  Google Scholar 

  6. Shim JU, Rose PG, Reale FR, Soto H, Tak WK, Hunter RE (1992) Accuracy of frozen-section diagnosis at surgery in clinical stage I and II endometrial carcinoma. Am J Obstet Gynecol 166:1335–1338

    CAS  PubMed  Google Scholar 

  7. Quinlivan JA, Petersen RW, Nicklin JL (2001) Accuracy of frozen section for the operative management of endometrial cancer. BJOG 108:798–803

    Article  CAS  PubMed  Google Scholar 

  8. Goff BA, Rice LW (1990) Assessment of depth of myometrial invasion in endometrial adenocarcinoma. Gynecol Oncol 38:46–48

    Article  CAS  PubMed  Google Scholar 

  9. Manfredi R, Mirk P, Maresca G, Margariti PA, Testa A, Zannoni GF, Giordano D, Scambia G, Marano P (2004) Local-regional staging of endometrial carcinoma: role of MR imaging in surgical planning. Radiology 231:372–378

    Article  PubMed  Google Scholar 

  10. Chung HH, Kang SB, Cho JY, Kim JW, Park NH, Song YS, Kim SH, Lee HP (2007) Accuracy of MR imaging for the prediction of myometrial invasion of endometrial carcinoma. Gynecol Oncol 104:654–659

    Article  PubMed  Google Scholar 

  11. Kayikcioglu F, Boran N, Meydanli MM, Tulunay G, Kose FM, Bulbul D (2002) Is frozen-section diagnosis a reliable guide in surgical treatment of stage I endometrial carcinoma? Acta Oncol 41:444–446

    Article  PubMed  Google Scholar 

  12. Kucera E, Kainz C, Reinthaller A, Sliutz G, Leodolter S, Kucera H, Breitenecker G (2000) Accuracy of intraoperative frozen-section diagnosis in stage I endometrial adenocarcinoma. Gynecol Obstet Invest 49:62–66

    Article  CAS  PubMed  Google Scholar 

  13. Sanjuan A, Cobo T, Pahisa J, Escaramis G, Ordi J, Ayuso JR, Garcia S, Hernandez S, Torne A, Martinez Roman S, Lejarcegui JA, Vanrell JA (2006) Preoperative and intraoperative assessment of myometrial invasion and histologic grade in endometrial cancer: role of magnetic resonance imaging and frozen section. Int J Gynecol Cancer 16:385–390

    Article  CAS  PubMed  Google Scholar 

  14. Case AS, Rocconi RP, Straughn JM Jr, Conner M, Novak L, Wang W, Huh WK (2006) A prospective blinded evaluation of the accuracy of frozen section for the surgical management of endometrial cancer. Obstet Gynecol 108:1375–1379

    PubMed  Google Scholar 

  15. Indermaur MD, Shoup B, Tebes S, Lancaster JM (2007) The accuracy of frozen pathology at time of hysterectomy in patients with complex atypical hyperplasia on preoperative biopsy. Am J Obstet Gynecol 196:e40–e42

    Article  PubMed  Google Scholar 

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Correspondence to Naoto Furukawa.

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Furukawa, N., Takekuma, M., Takahashi, N. et al. Intraoperative evaluation of myometrial invasion and histological type and grade in endometrial cancer: diagnostic value of frozen section. Arch Gynecol Obstet 281, 913–917 (2010). https://doi.org/10.1007/s00404-009-1263-1

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  • DOI: https://doi.org/10.1007/s00404-009-1263-1

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