Accuracy of intraoperative frozen section during laparoscopic management of early endometrial cancer.
OBJECTIVE
The aim of our retrospective study was to correlate the intraoperative frozen section (FS) and permanent section (PS) diagnosis among patients with early-stage endometrial cancer (FIGO Stage I).


METHODS
Retrospective analysis of clinical data. A set of 63 women were operated by the technique of laparoscopic assisted vaginal hysterectomy with bilateral salpingo-oophorectomy (LAVH with BSO). All probands had intraoperative FS biopsy performed with grading and myometrial invasion assessment. These data were then compared with PS diagnosis. Statistical evaluation was used to detect diagnostic accuracy of FS (sensitivity, specificity and positive vs negative predictive value, and accuracy rate).


RESULTS
The average age was 61 years, BMI 32.4 kg/m2 and operation time including lymphadenectomy (LAE) was 108.7 minutes. Sensitivity of FS was 77.8%, specificity 98.1%, positive predictive value (PPV) 87.5%, negative predictive value (NPV) 96.4% and accuracy rate 95.2%. Suboptimal surgical management due to underevaluation of FS biopsy compared to PS diagnosis occurred in 2 patients (3.2%).


CONCLUSIONS
Combination of LAVH with BSO and use of intraoperative FS enables the surgeon to individualize surgical treatment for every patient to the extent of either performing complete operation together with LAE or not.
Kucera
E
E
Institute for the Care of Mother and Child, 3rd Faculty of Medicine, Charles University, Prague, Czech Republic. ekucera@seznam.cz
Václav
H
H
Radovan
T
T
Otcenásek
M
M
Drahonovský
J
J
Feyereisl
J
J
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D005629:Frozen Sections; D006801:Humans; D007045:Hysterectomy, Vaginal; D010535:Laparoscopy; D008197:Lymph Node Excision; D008875:Middle Aged; D009215:Myometrium / Q000473:pathology; D010052:Ovariectomy; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity