title: Clinical analysis of intra-operative frozen section proven borderline tumors of the ovary.
abstract: OBJECTIVE
  We have assessed the accuracy of frozen section diagnosis and the outcomes of misdiagnosis in borderline tumors of the ovary (BTO) according to frozen section.
  
  
  METHODS
  All pathology reports with BTO in both frozen and permanent section analyses between 1994 and 2008 at Seoul St. Mary's Hospital were reviewed. Frozen section diagnosis and permanent section histology reports were compared. Logistic regression models were conducted to evaluate the correlation of patient and tumor characteristics with diagnostic accuracy. The clinical outcomes of misdiagnosis were evaluated.
  
  
  RESULTS
  Agreement between frozen section diagnosis and permanent histology was observed in 63 of 101 patients (62.4%). Among the 76 patients with frozen section proven BTO, under-diagnosis and over-diagnosis occurred in 8 of 76 (10.5%) and 5 of 76 patients (6.6%), respectively. Mean diameter of under-diagnosed tumor was larger than matched BTO (21.0+/-11.4 vs. 13.7+/-7.1; p=0.021). Tumor size 20 cm was determined as the optimal cut-off for under-diagnosis (50% sensitivity, 87.3% specificity). Among 8 under-diagnosed patients, no patient relapsed. Among 5 over-diagnosed patients, 2 patients < 35 years of age had fertility-preserving surgery.
  
  
  CONCLUSIONS
  Although frozen section diagnosis is an important and reliable tool in the clinical management of patients with ovarian tumors, over-diagnosis and under-diagnosis are relatively frequent in frozen proven BTO. Surgical decision-making for BTO based on frozen section diagnosis should be done carefully, especially in large tumors.
authors.affiliation: Department of Obstetrics and Gynecology, The Catholic University of Korea School of Medicine, Seoul, Korea.
authors.forename: Jin Hwi
authors.initials: JH
authors.lastname: Kim
authors.forename: Tae Jung
authors.initials: TJ
authors.lastname: Kim
authors.forename: Yong Gyu
authors.initials: YG
authors.lastname: Park
authors.forename: Sung Ha
authors.initials: SH
authors.lastname: Lee
authors.forename: Chung Won
authors.initials: CW
authors.lastname: Lee
authors.forename: Min Jong
authors.initials: MJ
authors.lastname: Song
authors.forename: Keun Ho
authors.initials: KH
authors.lastname: Lee
authors.forename: Soo Young
authors.initials: SY
authors.lastname: Hur
authors.forename: Seog Nyeon
authors.initials: SN
authors.lastname: Bae
authors.forename: Jong Sup
authors.initials: JS
authors.lastname: Park