title: Frozen section underestimates the need for surgical staging in endometrial cancer patients.
abstract: OBJECTIVE
  To compare the risk status for lymph nodal metastasis at frozen section in endometrial cancer by applying a model based on tumor grade and myometrial involvement.
  
  
  METHODS
  A retrospective analysis was performed on 174 early-stage endometrial cancer patients on whom an intraoperative frozen section was requested. Patients were retrospectively divided into low, intermediate, and high risk for lymph nodal involvement based on tumor grade and myometrial invasion based on Gynecologic Oncology Group 33 data. Concordance of risk status at frozen and permanent sections was performed.
  
  
  RESULTS
  Risk status at frozen and permanent sections were highly correlated (P < 0.01). Agreement between frozen and permanent sections was substantial (kappa = 0.625). In 16% of the cases, frozen section underestimated the risk when compared with permanent section.
  
  
  CONCLUSIONS
  Relying on intraoperative frozen section of the uterus to assess risk status for lymph nodal involvement in early-stage endometrial cancer patients leads to suboptimal management in a substantial number of cases.
authors: Jackson Memorial Hospital, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA. apapadia@med.miami.edu
authors: Andrea
authors: A
authors: Papadia
authors: Guglielmo
authors: G
authors: Azioni
authors: Bruno
authors: B
authors: Brusacà
authors: Ezio
authors: E
authors: Fulcheri
authors: Karen
authors: K
authors: Nishida
authors: Stefania
authors: S
authors: Menoni
authors: Fiona
authors: F
authors: Simpkins
authors: Joseph A
authors: JA
authors: Lucci
authors: Nicola
authors: N
authors: Ragni
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D005629:Frozen Sections; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods