Is thyroid frozen section too much for too little?
BACKGROUND
The role of frozen section (FS) in thyroid disease is controversial. The goal of this study was to identify a cohort of patients who may or may not benefit from FS.


METHODS
Two hundred thirty-one patients who underwent thyroidectomy were evaluated in regard to fine-needle aspiration (FNA), FS, and the extent of surgery.


RESULTS
In all, 155 patients underwent FNA, 140 patients underwent FS, and 103 patients had both. A final diagnosis of malignancy was obtained in 47 of 231 patients. FNA had a sensitivity of 50% and a specificity of 99%, and FS had a sensitivity of 50% and a specificity of 100% for diagnosing malignancy. Accounting for the clinical findings and FNA results, FS results altered the extent of thyroidectomy in 1 of 103 patients.


CONCLUSIONS
The increased costs for the operative time and the pathologists needed to obtain routine FS are not supported with any substantial benefit in patient outcome.
Richards
Melanie L
ML
Department of Surgery, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio 78229-3900, USA. richardsm@uthscsa.edu
Chisholm
Robert
R
Bruder
Jan M
JM
Strodel
William E
WE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D002648:Child; D005260:Female; D005629:Frozen Sections / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013959:Thyroid Diseases / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D013961:Thyroid Gland / Q000473:pathology* / Q000601:surgery*; D013965:Thyroidectomy