Accuracy of intra-operative frozen section in guiding surgical staging of endometrial cancer

Durdağ, Gülşen Doğan; Alemdaroğlu, Songül; Bolat, Fılız; Baran, Şafak Yılmaz; Şimşek, Seda Yüksel; Çelik, Hüsnü

doi:10.1007/s00404-021-05979-y

Cited by 7 publications

(7 citation statements)

References 26 publications

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“…Accuracy of IFS in determining cervical involvement was reported as 86.7%–100% in literature. 33 Karabagli et al reported 100% correlation between IFS and PS. 37 However, Gülşen et al reported that cervical involvement was detected with 50% sensitivity and 97.6% specificity.…”

Section: Discussionmentioning

confidence: 98%

“…A previous review reported a discrepancy of 35.9%–7.0% and 20.0%–16.2% on the final diagnosis for the D&C and Hys, respectively 32 . Regarding concordance, similar to the biopsy, there is some discordance between IFS and postoperative pathology 33 . Tumor grade evaluation by IFS has presented sensitivity of 40%–98%, specificity of 53%–98%, accuracy of 83%–89%, and correlation of 58%–88% 19,24,27 .…”

Section: Discussionmentioning

confidence: 98%

“…Karabagli et al reported 100% correlation between IFS and PS 37 . However, Gülşen et al reported that cervical involvement was detected with 50% sensitivity and 97.6% specificity 33 . The low sensitivity can be explained by the limited cervical examination at IFS.…”

Section: Discussionmentioning

confidence: 99%

“… 32 Regarding concordance, similar to the biopsy, there is some discordance between IFS and postoperative pathology. 33 Tumor grade evaluation by IFS has presented sensitivity of 40%–98%, specificity of 53%–98%, accuracy of 83%–89%, and correlation of 58%–88%. 19 , 24 , 27 Herein, the overall IFS consistency was moderate for postoperative pathology results (Kappa: 0.585) compared to D&C (0.226) and Hys (0.180).…”

Section: Discussionmentioning

confidence: 99%

“… 37 However, Gülşen et al reported that cervical involvement was detected with 50% sensitivity and 97.6% specificity. 33 The low sensitivity can be explained by the limited cervical examination at IFS. The lack of cervical involvement in some IFS reports resulted in our failure to evaluate this parameter.…”

Section: Discussionmentioning

confidence: 99%

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It is not the time to abandon intraoperative frozen section in endometrioid adenocarcinoma: A large‐scale, multi‐center, and retrospective study

Yang

Yin

et al. 2023

Cancer Medicine

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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It is not the time to abandon intraoperative frozen section in endometrioid adenocarcinoma: A large‐scale, multi‐center, and retrospective study

Yang

Yin

et al. 2023

Cancer Medicine

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Preoperative and intraoperative assessment of myometrial invasion in patients with FIGO stage I non-endometrioid endometrial carcinoma—a large-scale, multi-center, and retrospective study

Yang

Yin

et al. 2023

Diagn Pathol

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Introduction Myometrial invasion is a prognostic factor for lymph node metastases and decreased survival in non-endometrioid endometrial carcinoma patients. Herein, we explored the mode of myometrial invasion diagnosis in FIGO stage I non-endometrioid carcinoma and evaluated the differences in diagnostic efficiency among intraoperative frozen section (IFS), intraoperative gross examination (IGE), magnetic resonance imaging (MRI), and computed tomography (CT) in clinical practice. Finally, we suggested which test should be routinely performed. Method This was a historical cohort study nationwide with 30 centers in China between January 2000 and December 2019. Clinical data, including age, histology, method of myometrial invasion evaluation (MRI, CT, IGE, and IFS), and final diagnosis of postoperative paraffin sections, were collected from 490 non-endometrioid endometrial carcinoma (serous, clear cell, undifferentiated, mixed carcinoma, and carcinosarcoma) women in FIGO stage I. Results Among the 490 patients, 89.59% presented myometrial invasion. The methods reported for myometrial invasion assessment were IFS in 23.47%, IGE in 69.59%, MRI in 37.96%, and CT in 10.20% of cases. The highest concordance was detected between IFS and postoperative paraffin sections (Kappa = 0.631, accuracy = 93.04%), followed by IGE (Kappa = 0.303, accuracy = 82.40%), MRI (Kappa = 0.131, accuracy = 69.35%), and CT (Kappa = 0.118, accuracy = 50.00%). A stable diagnostic agreement between IFS and the final results was also found through the years (2000–2012: Kappa = 0.776; 2013–2014: Kappa = 0.625; 2015–2016: Kappa = 0.545; 2017–2019: Kappa = 0.652). Conclusion In China, the assessment of myometrial invasion in non-endometrioid endometrial carcinoma is often performed via IGE, but the reliability is relatively low in contrast to IFS. In clinical practice, IFS is a reliable method that can help accurately assess myometrial invasion and intraoperative decision-making (lymph node dissection or not). Hence, it should be routinely performed in non-endometrioid endometrial carcinoma patients.

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Comparison of frozen section accuracy with final pathology results in early clinical stage of endometrioid type endometrial cancer

ÖZGEN,

ÖZGEN

2023

The European Research Journal

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Objectives: We aimed to compare the accuracy of the depth of myometrial invasion determined by intraoperative frozen section in the early clinical stage of endometrioid type endometrial cancer, with the result of the final postoperative paraffin section. Methods: The study was carried out with 102 patients who were diagnosed with type 1-2 endometrioid endometrial cancer in the gynecology clinic of the state hospital between January 2015 and 2019. Retrospective demographic data, clinical characteristics, and pathology results of the patients who underwent surgical staging were recorded. Results: The mean age of the patients was 59.3 ± 9.1 years and 82.3% of the patients were in the postmenopausal period. The mean age of patients with a depth of myometrial invasion<1/2 was lower than myometrial invasion>1/2, which was statistically significant (p < 0.001). According to the final postoperative pathology results, 93.1% (n = 95) of the cases were diagnosed as FIGO stage 1. The subgroups were 66.7% stage 1a and 26.4% stage 1b. When the stage and grade distribution was made according to the final postoperative pathology result, stage 1a grade 2 endometrial cancer was the most common with a rate of 43.1%. Concordance of the intraoperative and postoperative pathology results for the depth of myometrial invasion was 84.3%, the specificity was 100%, the positive predictive value was 100%, and the negative predictive value was 86.76%. Conclusions: The accuracy of the intraoperative frozen section in endometrial cancers is quite higher. For this reason, intraoperative pathological examination results are important in terms of minimizing the complications of unnecessary surgery.

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Accuracy of intra-operative frozen section in guiding surgical staging of endometrial cancer

Cited by 7 publications

References 26 publications

It is not the time to abandon intraoperative frozen section in endometrioid adenocarcinoma: A large‐scale, multi‐center, and retrospective study

It is not the time to abandon intraoperative frozen section in endometrioid adenocarcinoma: A large‐scale, multi‐center, and retrospective study

Preoperative and intraoperative assessment of myometrial invasion in patients with FIGO stage I non-endometrioid endometrial carcinoma—a large-scale, multi-center, and retrospective study

Comparison of frozen section accuracy with final pathology results in early clinical stage of endometrioid type endometrial cancer

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