Frozen section evaluation of cervical cold knife cone specimens is accurate in the diagnosis of microinvasive squamous cell carcinoma

Giuntoli, Robert L.; Winburn, Kimberly A; Silverman, Montane B; Keeney, Gary L.; Cliby, William A.

doi:10.1016/j.ygyno.2003.08.014

Cited by 9 publications

(3 citation statements)

References 15 publications

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“…For microinvasive disease, the overall accuracy was 97.4%. This is similar to the 100% accuracy reported by Giuntoli et al [7] in their evaluation of conization with frozen section analysis in the evaluation of microinvasive carcinoma.…”

Section: Discussionsupporting

confidence: 89%

“…Previous studies of this approach have all been from academic centers in the United States [4, 7, 8] and other countries [5, 6, 9], and presumably pathologists at academic centers had extra training or interest in gynecologic malignancies. At MD Anderson Cancer Center, all specimens were reviewed by 1 of 6 pathologists subspecialized in the area of gynecologic pathology and therefore spend the majority of their time reviewing gynecology cases.…”

Section: Discussionmentioning

confidence: 99%

“…Other authors, however, have shown that the procedure adds an additional 30 to 45 minutes to the case. [6, 7] Certainly the benefits of avoiding the need for 2 separate procedures—conization followed by hysterectomy 6 weeks later—far outweigh this short additional operating time required for performing conization and definitive hysterectomy during the same procedure.…”

Section: Discussionmentioning

confidence: 99%

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Utility of conization with frozen section for intraoperative triage prior to definitive hysterectomy

Martinelli

Schmeler

Johnson³

et al. 2012

Gynecologic Oncology

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Objective-To review our experience with conization with intraoperative frozen section analysis and to compare results from our tertiary cancer center with those from 2 community hospitals. Luke's Episcopal Hospital-were reviewed. Findings on pathologic analysis of frozen sections, permanent loop electrosurgical excisional procedure/conization specimens, and hysterectomy specimens were compared for each patient, and results from the cancer center were compared to those from the community hospitals. Methods-TheResults-One hundred fifty-three patients met the inclusion criteria. Rates of accuracy of conization with frozen section analysis in predicting definitive pathologic findings were as follows: cervix with no residual disease after prior extirpative procedure 96.5% (95% CI 86.9-100%); cervical squamous carcinoma in situ, 95.4% (95% CI 84.5-100%); cervical adenocarcinoma in situ, 98.7% (95% CI 92.7-100%); microinvasive carcinoma, 97.4% (95% CI 90.1-100%); and invasive carcinoma ≥ 3 mm, 100%. Most importantly, conization with frozen section analysis was 100% accurate for triaging patients to simple or radical hysterectomy. Finally, this approach performed equally well in the cancer center with subspecialized pathologists and the 2 community hospitals with general pathologists.Conclusion-Conization with frozen section analysis is an effective technique for intraoperative triage of patients to immediate simple or radical hysterectomy and can be accurately performed in both academic and community hospitals.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Utility of conization with frozen section for intraoperative triage prior to definitive hysterectomy

Martinelli

Schmeler

Johnson³

et al. 2012

Gynecologic Oncology

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Uterine Cervix

Coffey¹,

Ramzy²

2011

Frozen Section Library: Gynecologic Pathology Intraoperative Consultation

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Schnellschnittdiagnostik bei Erkrankungen des weiblichen Genitaltrakts

et al. 2012

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Intraoperative frozen sections are particularly important for ovarian tumors because definitive preoperative histology is not possible. The diagnostic accuracy of frozen sections is highest for primary invasive ovarian carcinomas and benign ovarian lesions, followed by borderline tumors and poorest for ovarian metastases and rare neoplasms, such as germ cell tumors. Endometrial carcinoma should be diagnosed preoperatively by curettage or biopsy. For endometrioid endometrial carcinomas the indications for lymphadenectomy are often based on intraoperative assessment of the uterus. The differential diagnosis of low grade stromal neoplasms is based on myometrial invasion and can be supported by assessment of frozen sections as well as the diagnosis of other mesenchymal uterine tumors suspected of being malignant. Frozen sections of pelvic lymph nodes provide the possibility of immediate subsequent para-aortic lymphadenectomy in endometrial and cervical carcinomas but have recently lost importance. Sentinel node biopsy with intraoperative frozen section analysis is routinely performed only for vulval carcinoma. The German Association of Gynecological Oncology (AGO) recommends deferred diagnosis and a two stage surgical procedure for any doubtful intraoperative ovarian histology. Intraoperative frozen sections for endometrial carcinoma and lymphadenectomy specimens as well as for sentinel node biopsies are currently not recommended but are also not completely rejected.

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Frozen section evaluation of cervical cold knife cone specimens is accurate in the diagnosis of microinvasive squamous cell carcinoma

Cited by 9 publications

References 15 publications

Utility of conization with frozen section for intraoperative triage prior to definitive hysterectomy

Utility of conization with frozen section for intraoperative triage prior to definitive hysterectomy

Uterine Cervix

Schnellschnittdiagnostik bei Erkrankungen des weiblichen Genitaltrakts

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