The value of frozen section evaluation in the management of borderline ovarian tumors

Gültekin, Emre; Gültekin, Özge Elmastaş; Cıngıllıoğlu, Başak; Sayhan, Sevil; Şancı, Muzaffer; Yıldırım, Yusuf

doi:10.4103/0973-1482.92005

Cited by 20 publications

(24 citation statements)

References 20 publications

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“…In several studies, significant predictors of underdiagnosis were reported as histology, tumour size or preoperative serum CA-125 level (Houck et al 2000;Kim et al 2009;Gultekin et al 2011). In our study, none of these variables had a significant effect on the diagnosis type, probably due to a limited sample size.…”

Section: Discussioncontrasting

confidence: 70%

“…Gultekin et al (2011) reported 47.6% and 42.7% of serous and mucinous types of BOTs, respectively. According to the histopathologic diagnosis by Ayhan et al (2005), serous, mucinous and other types of BOTs were observed in 54 (54%), 39 (39%) and 7 (7%) patients, respectively consistent with the histological distribution of BOTs in our study.…”

Section: Discussionmentioning

confidence: 95%

“…In a study by Ilvan et al (2005), the sensitivity of frozen section diagnosis for benign, borderline and malignant tumours (n ¼ 617) was 100%, 87% and 87%, respectively and the specificity was 97%, 98% and 100%, respectively. Gultekin et al (2011) reported that underdiagnosis is a major problem associated with frozen section evaluations of BOTs, which restrict the diagnostic performance. In a series of 82 cases, the rates of correct diagnosis, overdiagnosis and underdiagnosis with frozen sections were 69.5%, 1.2% and 29.3%, respectively.…”

Section: Discussionmentioning

confidence: 98%

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The diagnostic value of frozen section for borderline ovarian tumours

Bozdağ

Güzin

Göçmen

et al. 2016

Journal of Obstetrics and Gynaecology

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Borderline ovarian tumours (BOTs) are characterised histologically by a low degree of cellular proliferation and nuclear atypia in the absence of infiltrative growth or stromal invasion. Surgical treatment has been a crucial component of BOT therapy. Surgical decisions are established intraoperatively via the frozen section. We evaluated the accuracy of frozen section diagnosis. The rate of correct diagnosis, underdiagnosis and overdiagnosis of BOTs with frozen sections was 78%, 17% and 5%, respectively. The sensitivity and positive predictive values for the diagnosis of BOTs with frozen sections were 82.3% and 93.3%, respectively. The positive likelihood ratio was 0.82 (95% CI: 0.85-0.96). The histological classification of BOTs had a significant effect on the accuracy of diagnosis (p = 0.001). Frozen section diagnosis is not suitable to be considered as the gold standard for a definitive diagnosis. Clinicians should be aware that using frozen sections is insufficient for the accurate staging of BOTs.

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Section: Discussioncontrasting

confidence: 70%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 98%

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The diagnostic value of frozen section for borderline ovarian tumours

Bozdağ

Güzin

Göçmen

et al. 2016

Journal of Obstetrics and Gynaecology

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“…2,3 The reliability of such diagnostic procedure is questionable and is largely depending on the pathologist's experience and the representative degree of the sections examined. 4,5 It is very important to distinguish frankly malignant tumours from borderline tumours as the latter have a much better prognosis and, because they are non-invasive, they are to be treated in a conservative way. On the other side, the optimal treatment of Stage I ovarian cancer is total abdominal hysterectomy, bilateral salpingo-oophorectomy and surgical staging.…”

Section: Introductionmentioning

confidence: 99%

Semi-quantitative contrast-enhanced MR analysis of indeterminate ovarian tumours: when to say malignancy?

Mansour

Saraya

El-Faissal

2015

BJR

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Objective: To evaluate the ability of dynamic post-contrast sequence to specify indeterminate ovarian masses with inconclusive MR features of malignancy. Since management is dramatically different, special focus on the ability to differentiate borderline from invasive malignancy was considered. Methods: 150 ovarian masses were detected by pelvic ultrasound in 124 patients. Masses had been considered for dynamic post-contrast MRI. We expressed the kinetic parameters (i.e. enhancement amplitude, time peak of maximal uptake and maximal slope) in the form of maximum relative enhancement percentage (MRE%), time of maximal peak of contrast uptake (T max ) and slope enhancement ratio (SER) curves. Histological findings were the gold standard of reference. Results: Malignant ovarian masses showed higher MRE% than benign and borderline masses (p , 0.001). T max was shorter for malignant than benign (p , 0.01) and borderline (p , 0.001) ovarian masses. SER curves were the most suggestive of malignancy with a specificity and accuracy of 85.7% and 84.7%, respectively. Conclusion: Dynamic contrast-enhanced MRI could be a specific sequence to differentiate ovarian masses with indeterminate MR morphology with a special discrimination for low potential from invasive ovarian malignancy. Advances in knowledge: The study evaluated the diagnostic performance of the individual parameters of dynamic post-contrast MR sequence in evaluating ovarian masses. Management divert between benign, borderline and invasive malignant masses; our work presented a cut-off value for the peak of contrast uptake of 120%, which helped in the differentiation between benign and malignant tumours; the SER curves with Type III (early washout) pattern that was indicative of invasive malignancy was more specific than borderline malignancy.

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“…In 5.6% ovarian cancer had been diagnosed and in 15.0% benign tumors, resulting in overtreatment or undertreatment respectively. Studies by Gultekin et al [31], Tempfer et al [32] and Liu et al [33] have revealed that the underdiagnosis rate for BOTs is 29.3%, 28% and 25.7% respectively. The retrospective multicenter pooled analysis reported by Tempfer et al [32] showed that in 280 women with a final diagnosis of BOT as many as 25% women had been diagnosed for benign lesions and 3.6% for ovarian cancer in the intraoperative cryosection.…”

Section: P R a C E O R Y G I N A L N E Ginekologiamentioning

confidence: 99%