Accuracy of Intraoperative Frozen Section Diagnosis in Clinical Stage I  and II Endometrial Carcinoma.

Kim, T J; Hong, S R; Lim, K T; Kim, E J; Chung, H W; Lee, K H; Park, J T; Park, I S; Lee, S H; Shim, J U

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Original Article

Korean Journal of Obstetrics & Gynecology 1998;41(5):1284-1289.
Published online January 1, 2001.

Accuracy of Intraoperative Frozen Section Diagnosis in Clinical Stage I and II Endometrial Carcinoma.

T J Kim, S R Hong, K T Lim, E J Kim, H W Chung, K H Lee, J T Park, I S Park, S H Lee, J U Shim

Abstract

From January 1991 to December 1996, a comparative analysis was conducted on 45 consecutive patients underwent hysterectomy for FIGO stage I & II endometrial carcinoma to determine the accuracy of intraoperative frozen section (IFS) diagnosis. The IFS diagnosis and the permanent section diagnosis were compared in myometrial invasion, cervical invasion, adnexal involvement, tumor differentiation, and histological types. In IFS diagnosis, deep myometrial invasion, poor histological type, poorly differentiated tumor, cervical invasion, and adnexal involvement were considered as high risk factors for the pelvic and the paraaortic nodal metastasis. The depth of myometrial invasion (superficial 1/2 vs deep 1/2) was accurately determined by IFS diagnosis in 44 of 45 cases (97.8%). The sensitivity was 93.3%, and the specificity was 96.8%. The following tumor characteristics were also accurately determined by frozen section at surgery: histologic types (91.1%), poorly differentiated tumor (95.6%), cervical invasion (91.1%), and adnexal involvement (100%). One case of deep myomerial invasion, four cases of cervical invasion, and two cases of poorly differentiated tumor were underestimated in IFS diagnosis. 15 of 20 patients (75%) were correctly identified by frozen section at surgery as having high risk for pelvic and paraaortic nodal metastasis. We conclude that IFS diagnosis is an important procedure that enables the surgeon to identify the patients at high risk for the pelvic and the paraaortic nodal metastasis.

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