title: Factors influencing the use of frozen section analysis in adnexal masses.
abstract: OBJECTIVE
  To determine the factors that influence the use of frozen section analysis in adnexal masses and the factors that predict malignancy.
  
  
  METHODS
  The study participants were women scheduled for adnexal mass surgery in 11 hospitals between 2005 and 2009. Factors that potentially influenced the use of frozen section analysis and potentially predicted malignancy were studied, such as menopausal status, CA 125 level, ultrasound characteristics, presence of adhesions, and tumor size. We used univariable and multivariable analyses to assess the factors.
  
  
  RESULTS
  A total of 670 patients were included in the study. The frozen section analyses for 323 patients (48%) showed 206 benign, 55 borderline, and 62 malignant adnexal masses. The CA 125 level, locularity of the tumor, and presence of solid areas predicted both the use of frozen section analysis and the presence of malignancy. The presence of adhesions predicted malignancy, but not the use of frozen section analysis. Menopausal status and tumor size predicted the use of frozen section analysis, but not malignancy.
  
  
  CONCLUSIONS
  Menopausal status and tumor size are associated with more use of frozen section analysis, but they have not been identified as factors associated with malignancy. Frozen section analysis is useful when the CA 125 levels are greater than 35 units/mL and when there are multilocular tumors, solid areas on ultrasonography, and adhesions revealed during surgery.
authors.affiliation: From the Radboud University Nijmegen Medical Centre, Department of Obstetrics and Gynecology, Nijmegen, the Netherlands; Rijnstate Hospital, Department of Obstetrics and Gynecology, Arnhem, the Netherlands; Canisius-Wilhelmina Hospital, Department of Obstetrics and Gynecology, Nijmegen, the Netherlands; Gelderse Vallei Hospital, Department of Obstetrics and Gynecology, Ede, the Netherlands; and Bernhoven Hospital, Department of Obstetrics and Gynecology, Oss, the Netherlands.
authors.forename: Petronella A J
authors.initials: PAJ
authors.lastname: van den Akker
authors.forename: Kirsten B
authors.initials: KB
authors.lastname: Kluivers
authors.forename: Anette L
authors.initials: AL
authors.lastname: Aalders
authors.forename: Marc P L M
authors.initials: MPLM
authors.lastname: Snijders
authors.forename: Rahul A K
authors.initials: RAK
authors.lastname: Samlal
authors.forename: Jos H A
authors.initials: JHA
authors.lastname: Vollebergh
authors.forename: Petra L M
authors.initials: PLM
authors.lastname: Zusterzeel
authors.forename: Leon F A G
authors.initials: LFAG
authors.lastname: Massuger
mesh_terms: D000291:Adnexal Diseases / Q000097:blood / Q000473:pathology* / Q000601:surgery; D018394:CA-125 Antigen / Q000097:blood; D005260:Female; D005629:Frozen Sections; D005833:Genital Neoplasms, Female / Q000097:blood / Q000473:pathology* / Q000601:surgery; D006801:Humans; D016015:Logistic Models; D008565:Membrane Proteins / Q000097:blood; D008593:Menopause; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D018394:CA-125 Antigen; C451759:MUC16 protein, human; D008565:Membrane Proteins