title: Reassessment of the utility of frozen sections in endometrial cancer surgery using tumor diameter as an additional factor.
abstract: OBJECTIVE
  The purpose of this study was to improve the reliability of frozen section with the use of tumor diameter (TD) as an additional factor and intraoperatively to identify a subgroup of early endometrial cancers that would not require lymphadenectomy.
  
  
  METHODS
  Data for 228 patients who underwent surgery with frozen section were analyzed retrospectively. Lymphadenectomy was performed in 86% of patients; the nodes were positive in 8%.
  
  
  RESULTS
  The accuracy of frozen section for myometrial invasion, grade, and low-risk prediction significantly increased with decreasing TD (P = .036) and was 98%, 95%, and 95%, respectively, when the TD was ≤3 cm. Patients with a TD of ≤2 cm and patients with a TD of 2-3 cm who had low-risk predictors had no nodal metastasis; patients with a TD of 2-3 cm who had intermediate-high risk predictors and a TD of >3 cm with any level of risk predictors were at risk of nodal metastases.
  
  
  CONCLUSIONS
  When the TD was ≤3 cm, the low-risk group that is defined by frozen section can be predicted accurately and safely to remain lymph-node metastasis free.
authors.affiliation: Gynecology Service, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Yanazume
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Saito
authors.forename: Takako
authors.initials: T
authors.lastname: Eto
authors.forename: Takeharu
authors.initials: T
authors.lastname: Yamanaka
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nishiyama
authors.forename: Masao
authors.initials: M
authors.lastname: Okadome
authors.forename: Kazuya
authors.initials: K
authors.lastname: Ariyoshi
mesh_terms: D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005629:Frozen Sections; D006801:Humans; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies