Role of Frozen Section in Intraoperative Assessment of Ovarian Masses: a Tertiary Oncology Center Experience.

Sukumaran, Renu; Somanathan, Thara; Mathews, Anitha; Kattor, Jayasree; Suchetha, S.; Nair, Rema Prabhakaran

doi:10.1007/s13193-014-0311-x

Cited by 25 publications

(15 citation statements)

References 17 publications

(20 reference statements)

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“…Given the low accuracy rate for borderline ovarian tumors, care and attention are required to develop this field (10,11,13,14,18). Most studies typically reported a sensitivity of 71-100% for the detection of malignancies by frozen section, and a specificity ranging from 96-100% (11,19,21,23,26,27). In our study, the sensitivity of malignant ovarian tumor detection was 93.3% and the specificity was 100%, reflecting that the frozen section examination was highly sensitive and specific to ovarian malignancy.…”

Section: Discussionsupporting

confidence: 55%

Diagnostic Accuracy Value of Intraoperative Frozen Section for Ovarian Neoplasms

Shahmoradi

Arab

2020

Indian J Gynecol Oncolog

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Background Accuracy of intraoperative frozen section diagnosis is extremely important in the evaluation of ovarian tumors so that suitable surgical procedures can be chosen. Methods This retrospective diagnostic accuracy study was conducted in the Department of Obstetrics and Gynecology, Emam Hossein Hospital. The case records of patients with ovarian mass who underwent surgery and intraoperatively frozen section assessments between September 2006 and December 2014 were analyzed. Demographic and clinical data, operative details, frozen section and final histopathology Examination (HPE) were reviewed from the medical records. Results one hundred and ninety three patients with ovarian masses undergoing surgery and frozen section were included. The frozen section diagnoses were benign in 155 (80.31%), borderline in 10 (5.18%), and malignant in 28 (14.51%), whereas the final diagnosis was benign in 154 (79.80%), borderline in 9 (4.66%), and malignant in 30 (15.54%). The overall accuracy of intra-operative frozen section diagnosis was 98.9%. The sensitivity for frozen section diagnosis was 100% for benign, 89% for borderline and 93.3% for malignant category, whereas the specificity was 97%, 99%, and 100%, respectively. There were 3 cases with discordance between the frozen section diagnoses and the final diagnoses, all of which were under diagnosed by frozen section. Conclusion Frozen section was found to be accurate and useful in the intraoperative assessment of patients with ovarian neoplasm. The results may help to determine the type and extent of surgery.

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Section: Discussionsupporting

confidence: 55%

Diagnostic Accuracy Value of Intraoperative Frozen Section for Ovarian Neoplasms

Shahmoradi

Arab

2020

Indian J Gynecol Oncolog

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“…The relative sensitivities were 99.2, 88.46, and 82.95 %, respectively, for benign, borderline, and malignant tumors. There were 18 false negative diagnoses; most of them belonged to the borderline group [ 10 ]. A few authors specifically focused on borderline ovarian tumors.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of intraoperative frozen section for the evaluation of ovarian neoplasms: an institutional experience

et al. 2016

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BackgroundOvarian neoplasms are a heterogeneous group of tumors including surface epithelial, germ cell and sex cord stromal tumors with a subset having low malignant potential (borderline tumors). While the surgical management plan differs in different categories of tumors, preoperative diagnosis is seldom available. In these circumstances, the role of frozen section becomes invaluable. In the current study, we aimed to evaluate the accuracy of the frozen section of ovarian tumors in our setup.MethodsIt was a retrospective study involving 141 cases of ovarian tumors undergoing surgical resection with frozen section evaluation from January 2009 to December 2014. After gross examination, one to five blocks were prepared on the frozen section depending upon the size of the specimen. After frozen section reporting, specimens were processed routinely for final paraffin section evaluation. Results of frozen and paraffin sections were categorized in benign, borderline, and malignant, and accuracy of frozen section was determined.ResultsOut of 141 cases, 107 were diagnosed as benign on final (paraffin) examination, while 6 were borderline and 28 were malignant. Out of 107 benign cases, 45 were non-neoplastic cystic lesions of the ovary including endometriotic, follicular, and corpus luteal cysts. The most common benign neoplastic tumor was mature cystic teratoma (20 cases) followed by mucinous cystadenoma (19 cases), serous cystadenoma (14 cases), sex cord stromal tumors (8 cases), and Brenner tumor (1 case). Among borderline cases, four cases were serous and two of mucinous neoplasms. The most common malignant neoplasm was serous carcinoma (11 cases) followed by mucinous carcinoma (6 cases). The overall accuracy of frozen section diagnosis is above 99 %. The sensitivity and specificity for benign tumors were found to be 100 and 97 %, respectively. The sensitivity and specificity for borderline tumors was 83 and 99 %, respectively, while for malignant tumors, it was 96 and 100 %, respectively.ConclusionsWe found a high sensitivity and specificity of frozen section for the diagnosis of ovarian tumors and to determine its malignant potential. Therefore, it should always be used when the preoperative diagnosis is not definite to govern extent of surgical resection. However, under-diagnosis can occur in tumors of borderline category which can be minimized by increased sampling on the frozen section.

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“…The overall accuracy in our study is 81.7%, this value is less than other values in previous studies which range from (90% to 97%) [1] [6]- [8] but still accepted. The overall accuracy which had shown in previous studies was 93.8% [8], 95.5% [1], 91.85% in [9], 97.1% [5] and this variation may be attributed to our small sample size and the raised age of cases. The sensitivity of benign, borderline and malignant ovarian tumors found 100%, 100% and 75.32%, respectively ( Table 3), and the specificity was for benign, borderline and malignant 82%, 95.19% and 100%, respectively which correlate with previous studies [1] [6]- [8].…”

Section: Discussionmentioning

confidence: 64%

Frozen Section in Postmenopausal Women Presented with Suspicious Ovarian Masses, Does It Have a Role?

Refky¹,

Gamal²,

Hamed³

et al. 2015

JCT

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Background: Frozen section (FS) has a valuable role in the diagnosis of ovarian tumors. It is considered a pivotal point in guiding the surgical therapy, particularly in premenopausal women. In postmenopausal women, it may be required as well to avoid unnecessary surgical staging in benign ovarian tumors. Aim: This study aims to evaluate the accuracy of intraoperative frozen section in ovarian neoplasms in postmenopausal women. Materials and Methods: A retrospective analysis was done for intraoperative FS for suspected ovarian neoplasms. The study was conducted in Oncology Center, Mansoura University from March 2008 to December 2014. The frozen and paraffin section reports were compared, and overall accuracy, sensitivity, specificity, positive and negative predictive values were determined. Results: The study included 105 patients and the overall accuracy of FS in determining malignancy was 81.7%. The sensitivity for malignant tumors was 75.32% with specificity of 100%. For benign tumors, the sensitivity and specificity were 100% and 93%, respectively. Borderline tumors had the lowest sensitivity of 100% with specificity of 95.19%. Conclusion: The present study concurs that frozen section is an accurate test for diagnosis of benign and malignant tumors in postmenopausal women thus determining the extent of surgery done for them. On the other hand, accuracy rates for borderline tumors are low.

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Role of Frozen Section in Intraoperative Assessment of Ovarian Masses: a Tertiary Oncology Center Experience.

Cited by 25 publications

References 17 publications

Diagnostic Accuracy Value of Intraoperative Frozen Section for Ovarian Neoplasms

Diagnostic Accuracy Value of Intraoperative Frozen Section for Ovarian Neoplasms

Accuracy of intraoperative frozen section for the evaluation of ovarian neoplasms: an institutional experience

Frozen Section in Postmenopausal Women Presented with Suspicious Ovarian Masses, Does It Have a Role?

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