title: The clinical value of preoperative and intraoperative assessments in the management of endometrial cancer.
abstract: OBJECTIVE
  In this study, we aimed to investigate the diagnostic accuracy of preoperative assessment and frozen-section analysis (FSA) in endometrial cancer by comparing postoperative histopathology.
  
  
  METHODS
  A total of 72 consecutive patients with endometrial cancer were included in this study. Comprehensive surgical staging was performed in all patients. After abdominal hysterectomy, the uterus was investigated for FSA. For preoperative analysis, histological grade and histological subtypes were investigated. In FSA, all the specimens were reviewed for histological subtype, histological grade, depth of myometrial invasion, lymphovascular space invasion (LVI), and cervical involvement. These results were compared with final histopathology. Data were statistically analyzed.
  
  
  RESULTS
  The accuracy of preoperative examination was 95.8% (69/72) for histological type and 90% (65/72) for histological grade. In the frozen section, the accuracies of histological grade and subtype were found to be 92% and 98%, respectively. However, histological grade had 43% sensitivity in preoperative and intraoperative assessments. Myometrial invasion and LVI were correctly diagnosed in 93% and 94% of the cases, respectively. The risk assessment was correctly determined in 63 (87%) of 72 patients. Five patients were underclassified, and there was no lymph node invasion in these patients after final histopathology. Lymph node invasion was higher in patients with grade 3 classification, deep myometrial invasion, positive cervical involvement, and LVI.
  
  
  CONCLUSIONS
  Frozen-section analysis is a feasible method for the management of the patients with endometrial cancer. However, preoperative and intraoperative assessment of histological grade has lower sensitivity in endometrial cancer.
authors.affiliation: Department of Obstetrics and Gynecology, Meram Medical Faculty, Selçuk University, Konya, Turkey.
authors.forename: Cetin
authors.initials: C
authors.lastname: Celik
authors.forename: Suna
authors.initials: S
authors.lastname: Ozdemir
authors.forename: Hasan
authors.initials: H
authors.lastname: Esen
authors.forename: Osman
authors.initials: O
authors.lastname: Balci
authors.forename: Osman
authors.initials: O
authors.lastname: Ylmaz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005629:Frozen Sections; D006801:Humans; D007044:Hysterectomy; D007430:Intraoperative Care; D008198:Lymph Nodes; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009215:Myometrium / Q000473:pathology* / Q000601:surgery; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010386:Pelvic Neoplasms / Q000556:secondary* / Q000601:surgery; D011300:Preoperative Care; D011379:Prognosis; D015996:Survival Rate