Intraoperative Consultation in Gynecologic Pathology: A 6-Year Audit at a Tertiary Care Medical Center

Ismiil, Nadia; Ghorab, Zeina; Nofech‐Mozes, Sharon; Plotkin, Anna; Covens, Allan; Osborne, R.; Kupets, Rachel; Khalifa, Mahmoud A.

doi:10.1111/igc.0b013e318199617b

Cited by 18 publications

(12 citation statements)

References 26 publications

(14 reference statements)

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“…Accuracy is suboptimal on large MOT as the borderline and the malignant MOT have some histological characteristics in common. 18 There are studies to support incidental appendicectomy is a safe procedure in women undergoing elective surgery without any significant morbidity or increase in the length of stay for this added procedure. 19,20 Table 3 summarizes the correlation between the histological or microscopic appearance and the macroscopic appearance of appendices removed as part of staging procedure for borderline and malignant MOT.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Appendicectomies at Surgery for Mucinous Ovarian Neoplasms: Report From A UK Center and Review of Literature

Mukhopadhyay

Rajab

Nobbenhuis

et al. 2016

Int J Gynecol Cancer

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Section: Discussionmentioning

confidence: 99%

Outcome of Appendicectomies at Surgery for Mucinous Ovarian Neoplasms: Report From A UK Center and Review of Literature

Mukhopadhyay

Rajab

Nobbenhuis

et al. 2016

Int J Gynecol Cancer

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“…In total, 921 women were identified, of which 691 (75.0%) were diagnosed with borderline and 230 (25.0%) with "at least borderline" on frozen section evaluation. Ismiil et al, 16 Ureyen et al 23…”

Section: Summary Of Included Studies and Patientsmentioning

confidence: 99%

“…6,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Eleven of these actually reported on numbers of women with such frozen section diagnoses, using "at least borderline". 11,12,14,16,22,23,[25][26][27][28]30 The study by Robinson et al was excluded from quantitative analysis because it was unclear whether the qualifying terms used in 11 women indicated a suspicion of a borderline ovarian tumor or invasive carcinoma (eg "suggestive of"). 11 The studies by Nili et al 26 and Yoshida et al 30 were also excluded from quantitative analysis because only the number of women with an "at least borderline" frozen section diagnosis prior to a permanent diagnosis of invasive carcinoma were reported.…”

Section: Evidence Acquisitionmentioning

confidence: 99%

Frozen section diagnosis of borderline ovarian tumors with suspicious features of invasive cancer is a devil’s dilemma for the surgeon: A systematic review and meta‐analysis

Decker

Jaroch

Edens

et al. 2021

Acta Obstet Gynecol Scand

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Introduction: Frozen section diagnoses of borderline ovarian tumors are not always straightforward and a borderline frozen section diagnosis with suspicious features of invasive carcinoma (reported as "at least borderline" or synonymous descriptions) presents us with the dilemma of whether or not to perform a full surgical staging procedure. By performing a systematic review and meta-analysis, the prevalence of straightforward borderline and "at least borderline" frozen section diagnoses, as well as proportion of patients with a final diagnosis of invasive carcinoma in these cases, were assessed and compared, as quantification of this dilemma may help us with the issue of this clinical decision. Material and methods: PubMed, EMBASE and Cochrane library databases were searched and studies discussing "at least borderline" frozen section diagnoses were included in the review. Numbers of specific frozen section diagnoses and subsequent final histological diagnoses were extracted and pooled analysis was performed to compare the proportion of patients diagnosed with invasive carcinoma following borderline and "at least borderline" frozen section diagnoses, presented as risk ratio and risk difference with 95% confidence intervals (95% CI). Results: Of 4940 screened records, eight studies were considered eligible for quantitative analysis. A total of 921 women was identified and 230 (25.0%) of these women were diagnosed with "at least borderline" ovarian tumor at the time of frozen section. Final histological diagnoses were reported in five studies, including 61 women with an "at least borderline" diagnosis and 290 women with a straightforward borderline frozen section diagnosis. Twenty-five of 61 women (41.0%) of the "at least borderline" group had invasive cancer at final diagnosis, compared with 28 of 290 women (9.7%) of the straightforward borderline frozen section group (risk difference −0.34, 95% CI −0.53 to −0.15; relative risk 0.25, 95% CI 0.13-0.50). Conclusions: Women diagnosed with "at least borderline" frozen section diagnoses were found to have a higher chance of carcinoma upon final diagnosis when compared This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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“…7 Borderline mucinous tumours comprised the single largest source of error in frozen section. 8,9 Among the several cytological techniques applied to ovarian specimens, scrape cytology is often considered the most suitable. 2 The description of the imprint smears of fresh tissues in the rapid microscopic diagnosis of tumours are the milestone in the development.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic utility of imprint cytology of ovarian neoplasm: A cyto-histological comparison

Ivan¹,

Chacko²,

Thomas³

2020

ACHR

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Background: Intra-operative cytology (IOC) is a method of intra-operative pathological evaluation of cytology smears. The most important indication for IOC is to establish or confirm diagnosis rapidly. Other advantages of IOC are its simple, inexpensive, excellent preservation of cellular details, with no loss of tissues as occurs with cryostat sections and adequacy of surgical margins. Frozen sections are well established method for providing rapid and accurate intra-operative diagnosis. Objective: To evaluate the diagnostic utility of imprint cytology and assess the accuracy of imprint cytology with histopathological diagnosis obtained from ovarian neoplasm. Materials and Methods: Imprint smears were prepared immediately from all the ovariotomy specimens. The specimens were sent for histopathology along with prepared smears to categorize as benign, borderline and malignant. Sensitivity, specificity and accuracy were assessed. Results : Among the 99 specimens studied, 80 were benign, 9 borderline and 10 malignancy according to histopathology. We found that sensitivity, specificity, for benign lesions were 100%, 42.1% and for malignant lesions were 80%, 91.9% respectively. The overall accuracy was 89%. Conclusion : Imprint smear of ovarian neoplasm gives a rapid diagnosis with 89% accuracy against histopathology with added advantages. Imprint cytology is an adjunct to frozen section for providing an intra-operative diagnosis; however, in resource poor settings, it can be used as a stand-alone method for aiding intra-operative decision making.

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Intraoperative Consultation in Gynecologic Pathology: A 6-Year Audit at a Tertiary Care Medical Center

Cited by 18 publications

References 26 publications

Outcome of Appendicectomies at Surgery for Mucinous Ovarian Neoplasms: Report From A UK Center and Review of Literature

Outcome of Appendicectomies at Surgery for Mucinous Ovarian Neoplasms: Report From A UK Center and Review of Literature

Frozen section diagnosis of borderline ovarian tumors with suspicious features of invasive cancer is a devil’s dilemma for the surgeon: A systematic review and meta‐analysis

Diagnostic utility of imprint cytology of ovarian neoplasm: A cyto-histological comparison

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