The diagnostic value of frozen section for borderline ovarian tumours

Bozdağ, Halenur; Güzin, Kadir; Göçmen, Ahmet; Kabaca, Sedef; Usta, Akın; Akdeniz, Esra

doi:10.3109/01443615.2015.1133574

Cited by 10 publications

(6 citation statements)

References 24 publications

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“…Frozen section could not yield an accurate diagnosis in borderline ovarian tumors (Bozdag et al, 2016). Increased numbers of frozen sections could not increase the accuracy of the reading (Ayhan et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

The Evaluation of Intra-Operative Frozen Section Diagnosis Accuracy of Ovarian Tumors; Old Fashioned Not Out of Fashion

Muruthapongsatorn

Inploy

Prommas

et al. 2019

Asian Pac J Cancer Prev

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Section: Discussionmentioning

confidence: 99%

The Evaluation of Intra-Operative Frozen Section Diagnosis Accuracy of Ovarian Tumors; Old Fashioned Not Out of Fashion

Muruthapongsatorn

Inploy

Prommas

et al. 2019

Asian Pac J Cancer Prev

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“…The authors concluded that frozen section should be used cautiously in borderline tumors, particularly in older patients and in mucinous tumors [18]. Other studies suggest that frozen section is insufficient for accurate diagnosis of BOTs due to risk of underdiagnosis [19,20]. The present study highlights the continued challenges of borderline tumors diagnosis at FS with 13 discrepant cases, 3 of whom, required additional surgery.…”

Section: Discussionmentioning

confidence: 64%

Utility of Frozen Section in the Evaluation of Borderline Ovarian Tumors: A Single Institution Experience

Huang¹

2019

JGO

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Background: Borderline ovarian tumors (BOTs) account for a 10-15% subset of all primary ovarian epithelial neoplasms. Preoperative imaging and serologic markers are often inconclusive at distinguishing between benign, premalignant, and malignant ovarian tumor. Limitations at time of frozen section (FS) are relatively well known, and misinterpretation may occur potentially leading to over-and under-treatment. We evaluated all cases of BOTs submitted for FS in our institution to determine the accuracy of intraoperative diagnosis when compared with the final pathology, and possibly identify features that may guide surgical staging decision-making. Methods: We identified all intraoperative diagnoses of BOTs from our institution in a 12-year period. Clinical and pathologic data were abstracted. Intraoperative pathology diagnosis was compared to final pathologic diagnosis. Statistical analysis was performed using chi-square and logistic regression. Results: There were 80 cases included for analyses, of which 39 (48.8%) were serous borderline tumor (SBT), 18 (22.5%) mucinous borderline tumors (MBT), 1 (1.2%) endometrioid borderline tumor, and 22 (27.5%) at least borderline tumor (of various histologies). There were 13 cases with a discrepancy between FS and final diagnosis. In patients with a discrepancy where final pathology demonstrated carcinoma, 4/11 (36.3%) were not staged or had incomplete staging. Subsequently, 3/4 (75%) underwent a re-operation for staging purposes. In patients with discrepant pathology, discrepancy was more common 8/37 (21.6%) among non-gynecologic pathologists compared to 5/43 (11.6%) among gynecologic pathologists, but not statistically significant (p=0.23). When "at least borderline" tumor was diagnosed at FS, 10/22 (45%) had invasive malignancies on final pathology compared to diagnosis of BOT "only" on FS; on which 1/58 (1.7%) had invasive carcinoma. The cases with histologic diagnosis of BOT "only" were associated with significantly reduced discrepancy (OR 0.04 [95% CI 0.01-0.18], p< 0.001). Conclusion: In conclusion, use of intraoperative evaluation for ovarian tumors is a useful diagnostic tool but has its limitations. In intraoperative cases where pathologists call "at least borderline", strong consideration for surgical staging should be contemplated with re-evaluation of preoperative testing. Moreover, when possible, direct communication between surgeon and pathologist at time of FS diagnosis of BOT may be valuable.

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“…Unlike in many other tumors, no preoperative pathological diagnosis should be performed in early ovarian cancer. Oncologists depend mainly on pathological examination of the excised ovarian tumor (11) . Performing a complete surgical staging for every patient with a complex ovarian mass is a double-edged weapon.…”

Section: Discussionmentioning

confidence: 99%

Feasibility, accuracy and advantages of frozen section examination of ovarian masses with normal tumor markers. A tertiary referral center experience

Elfeky¹,

Hamdy²,

Roshdy³

et al. 2022

Curr Gynecol Oncol

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Introduction: Proper design of the operative plan for patients with ovarian masses is a must to avoid unnecessary surgical steps, the need for another surgery or empirical chemotherapy. We investigated the role of frozen section examination in this design. Methods: This was a prospective study in which 64 complex adnexal masses with normal tumor markers underwent frozen section examination. The patients were divided into two parallel groups: group A in which the decision whether to proceed for complete staging or not was built on the result of the examination, and group B in which the patients underwent panhysterectomy at baseline regardless of their frozen section examination result. Postoperative stay, estimated blood loss and the incidence of complications were compared. Results: When comparing the two groups, including patients with tumors that turned out to be benign, there were no significant differences in postoperative complications, but there were for the operative time (60 vs. 120 minutes, p = 0.004) and blood loss, which were significantly lower in group A (50 vs. 100 mL, p = 0.001), and hospital stay, which was statistically insignificantly shorter than in group B (1 day vs. 2 days, p = 0.062). The sensitivity of frozen section examination for benign, borderline, and malignant ovarian masses was 91.9%, 76.9%, 53.3%, respectively, while the specificity was 85.2%, 87.5%, 95.9% and the overall diagnostic accuracy was 89.6%, 85.2%, 85.9%, respectively. Conclusion: The use of frozen section examination in the assessment of complex ovarian masses in patients with normal tumor markers offers an acceptable accuracy with a significant decrease of the operative time, blood loss as well as hospital stay.

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The diagnostic value of frozen section for borderline ovarian tumours

Cited by 10 publications

References 24 publications

The Evaluation of Intra-Operative Frozen Section Diagnosis Accuracy of Ovarian Tumors; Old Fashioned Not Out of Fashion

The Evaluation of Intra-Operative Frozen Section Diagnosis Accuracy of Ovarian Tumors; Old Fashioned Not Out of Fashion

Utility of Frozen Section in the Evaluation of Borderline Ovarian Tumors: A Single Institution Experience

Feasibility, accuracy and advantages of frozen section examination of ovarian masses with normal tumor markers. A tertiary referral center experience

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