title: The evaluation of reliability and contribution of frozen section pathology to staging endometrioid adenocarcinomas.
abstract: OBJECTIVE
  To evaluate the reliability and accuracy of intraoperative pathological findings, compared to permanent section (PS) and to understand contributions of frozen section (FS) to final staging in patients with endometrioid carcinomas.
  
  
  METHODS
  This is a retrospective analysis of 79 patients undergoing intraoperative FS and with endometrioid adenocarcinomas. Intraoperative pathological findings were compared with final results as to grade, depth of myometrial invasion (MI), cervical involvement, lymphovascular space invasion (LVSI) and stage. We also analyzed whether staging procedures like pelvic or para-aortic lymph node metastasis, peritoneal cytology and extension beyond of uterus were related to FS findings. Staging was based on the FIGO 2009.
  
  
  RESULTS
  FS results were agreement in 89.9 % for grade, 88.6 % for depth of MI, 100 % for cervical invasion, and 92.4 % for LVSI, compared with PS. On FS, 12, 16.6 and 44.4 % of specimens in stages of IA, IB and II became upstaged in final pathology, respectively. Of 79 cases, 5 (6.3 %) were upstaged to IIIC1, and 3 (3.8 %) were upstaged to IIIC2 because of lymph node metastasis. A significant relationship was detected between lymph node metastasis, and FS grades (p = 0.001), LVSI (p = 0.000), cervical invasion (p = 0.006) and MI (p = 0.001).
  
  
  CONCLUSIONS
  We consider that intraoperative FS is a useful procedure to identify poor prognostic pathological factors. While grading, depth of MI, cervical stromal invasion and LVSI on FS are significant in predicting lymph node metastasis, the existence of cervical stromal invasion and LVSI should be considered more effective parameters in the identification of metastatic endometrial cancer risks.
authors.affiliation: Department of Pathology, Medical School of Selcuk University, Alaeddin Keykubad Campus, 42075, Selcuklu, Konya, Turkey, pinarkarabagli@yahoo.com.
authors.forename: Pinar
authors.initials: P
authors.lastname: Karabagli
authors.forename: Serdar
authors.initials: S
authors.lastname: Ugras
authors.forename: Burcu Sanal
authors.initials: BS
authors.lastname: Yilmaz
authors.forename: Cetin
authors.initials: C
authors.lastname: Celik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018269:Carcinoma, Endometrioid / Q000473:pathology*; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D005629:Frozen Sections; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging / Q000379:methods*; D010388:Pelvis / Q000473:pathology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012306:Risk