Accuracy of intraoperative frozen-section diagnosis in stage I endometrial adenocarcinoma.
The purpose of our study was to determine if frozen-section diagnosis accurately identified patients suffering from endometrial adenocarcinoma FIGO stage I for surgical staging consisting of total abdominal hysterectomy, bilateral salpingo-oophorectomy, peritoneal cytology, and complete bilateral pelvic lymphadenectomy in moderately differentiated tumors with myometrial invasion. In all poorly differentiated tumors, and in all tumors with deep myometrial invasion (more than 50%) surgical staging included additional para-aortic lymphadenectomy. We performed a retrospective study including 70 patients. Frozen-section diagnosis of myometrial invasion and tumor grade was compared with permanent-section diagnosis. The accuracy rates were determined, and compared with accuracy rates of frozen-section diagnosis in the literature, and a total accuracy rate for 624 patients suffering from stage I endometrial adenocarcinoma was evaluated. In our patient collective, the overall accuracy rate of frozen-section diagnosis for myometrial invasion and tumor grade was 80 and 84%, respectively. In the five comparable studies, the mean accuracy rate for myometrial invasion and tumor grade was 89 and 84%, respectively. In combination with the five comparable studies our recent study produced an accuracy rate of frozen-section diagnosis for myometrial invasion and tumor grade of 88 and 84% in 624 patients, respectively. Despite an accuracy level of frozen-section diagnosis for myometrial invasion of 80 and 84% for tumor grade in our patient collective, all patients who required surgical staging were accurately identified.
Kucera
E
E
Department of Gynecology and Obstetrics, Gynecopathologic Unit, University of Vienna, Austria. elisabeth.kucera@akh-wien.ac.at
Kainz
C
C
Reinthaller
A
A
Sliutz
G
G
Leodolter
S
S
Kucera
H
H
Breitenecker
G
G
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D005260:Female; D005629:Frozen Sections; D006801:Humans; D007432:Intraoperative Period; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012680:Sensitivity and Specificity