Accuracy of intraoperative frozen section analysis in borderline tumors of the ovary: A retrospective analysis of 96 cases and review of the literature

Tempfer, Clemens; Polterauer, Stephan; Bentz, Eva-Katrin; Reinthaller, Alexander; Hefler, Lukas

doi:10.1016/j.ygyno.2007.06.008

Cited by 106 publications

(103 citation statements)

References 34 publications

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“…Till now, BOTs are difficult to diagnose without operation and biopsy. Frozen section during the operation is of limited accuracy for the diagnosis of BOTs, with reported accuracy of only 56-89% [61][62][63][64].…”

Section: Nonmalignant Cyst Of Ovarymentioning

confidence: 99%

Physiopathological factors affecting the diagnostic value of serum HE4-test for gynecologic malignancies

Duan

et al. 2016

Expert Review of Molecular Diagnostics

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Section: Nonmalignant Cyst Of Ovarymentioning

confidence: 99%

Physiopathological factors affecting the diagnostic value of serum HE4-test for gynecologic malignancies

Duan

et al. 2016

Expert Review of Molecular Diagnostics

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“…However, frozen section diagnosis of BTO is less reliable than frozen section diagnosis of benign or malignant ovarian tumors. [5][6][7][8][9][10][11][12][13][14] Thus, some investigators have sought to find significant factors related to misdiagnosis. Houck et al 8 found that mucinous histology was the only significant predictor for under-diagnosis by frozen section.…”

Section: Introductionmentioning

confidence: 99%

Clinical analysis of intra-operative frozen section proven borderline tumors of the ovary

Kim

Park

et al. 2009

J Gynecol Oncol

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Objective:We have assessed the accuracy of frozen section diagnosis and the outcomes of misdiagnosis in borderline tumors of the ovary (BTO) according to frozen section. Methods: All pathology reports with BTO in both frozen and permanent section analyses between 1994 and 2008 at Seoul St. Mary's Hospital were reviewed. Frozen section diagnosis and permanent section histology reports were compared. Logistic regression models were conducted to evaluate the correlation of patient and tumor characteristics with diagnostic accuracy. The clinical outcomes of misdiagnosis were evaluated. Results: Agreement between frozen section diagnosis and permanent histology was observed in 63 of 101 patients (62.4%). Among the 76 patients with frozen section proven BTO, under-diagnosis and over-diagnosis occurred in 8 of 76 (10.5%) and 5 of 76 patients (6.6%), respectively. Mean diameter of under-diagnosed tumor was larger than matched BTO (21.0±11.4 vs. 13.7±7.1; p=0.021). Tumor size 20 cm was determined as the optimal cut-off for under-diagnosis (50% sensitivity, 87.3% specificity). Among 8 under-diagnosed patients, no patient relapsed. Among 5 over-diagnosed patients, 2 patients ＜ 35 years of age had fertility-preserving surgery. Conclusion: Although frozen section diagnosis is an important and reliable tool in the clinical management of patients with ovarian tumors, over-diagnosis and under-diagnosis are relatively frequent in frozen proven BTO. Surgical decision-making for BTO based on frozen section diagnosis should be done carefully, especially in large tumors.

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“…Sampling error was considered to be the main reason for the diagnostic discrepancy in most studies, predominantly in some groups of tumors, in which there was remarkable heterogeneity of tumor from areas to areas within the same ovarian mass, such as mucinous tumors and teratomas. Frozen section may fail to sample the most severe lesion or frankly malignant area in a limited number of sections intraoperatively [15]. Another factor that causes difficulty in frozen section diagnosis is the quality of sections prepared by this technique that limits the evaluation of cellular detail.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study between Intraoperative Frozen Section and Scrape Smear Cytology in the Diagnosis of Ovarian Neoplasm

Abdelghany¹,

Arafa²,

Madkour³

et al. 2015

OJOG

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Objective: The aim of this work is to compare between intraoperative frozen section and scrape smear cytology in the diagnosis of ovarian neoplasm. Method: This study was performed between March 2011 and March 2012, on 50 patients presented with ovarian mass. Gross examination of the tumor removed was done by inspection and palpation. The specimen was then cut with a sharp knife into two halves. The area was scraped with a sharp scalpel or the end of a glass slide, depending upon the type of tissue. A semifluid drop thus obtained was spread over a glass slide. One to four slides per case were taken from different representative areas. The slides were labelled and immediately put into 95% ethyl alcohol and stained with hematoxylin-eosin. The specimens were then fixed in formalin. Paraffin blocks of the sections were processed in the routine way and sections were stained with hematoxylin and eosin (H and E). Assessment of the overall accuracy of the intraoperative diagnosis was classified as concordant or discordant. Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of scraping technique in the diagnosis of benign ovarian masses were 100%, 95.2%, 96.7%, 100% and 98% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of scraping technique in the diagnosis of border line ovarian masses were 100%, 93.4%, 25%, 100% and 94% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of scraping technique in the diagnosis of malignant ovarian masses were 80%, 100%, 100%, 88.2% and 92% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of frozen section in the diagnosis of benign ovarian masses were 100%, 100%, 100%, 100% and 100% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of frozen section in the diagnosis of borderline * Corresponding author. A. M. Abdelghany et al. 29ovarian masses were 100%, 95.9%, 33.3%, 100% and 96% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of frozen section in the diagnosis of malignant ovarian masses were 90%, 100%, 100%, 93.8% and 96% respectively. Conclusion: Frozen section is more accurate than smear preparations in the intraoperative assessment of ovarian tumors in this study. However, the cytology preparations were helpful in supporting the histological diagnoses, and in some cases, provided additional useful information. Thus, cytology has a complementary role to frozen section in the intraoperative assessment of ovarian lesions. At the centers where the facilities of frozen section are not available, intraoperative scrape cytology is a useful tool for intraoperative diagnosis of tumor.

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Accuracy of intraoperative frozen section analysis in borderline tumors of the ovary: A retrospective analysis of 96 cases and review of the literature

Cited by 106 publications

References 34 publications

Physiopathological factors affecting the diagnostic value of serum HE4-test for gynecologic malignancies

Physiopathological factors affecting the diagnostic value of serum HE4-test for gynecologic malignancies

Clinical analysis of intra-operative frozen section proven borderline tumors of the ovary

Comparative Study between Intraoperative Frozen Section and Scrape Smear Cytology in the Diagnosis of Ovarian Neoplasm

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