Intraoperative evaluation of myometrial invasion and histological type and grade in endometrial cancer: diagnostic value of frozen section

Arch Gynecol Obstet. 2010 May;281(5):913-7. doi: 10.1007/s00404-009-1263-1. Epub 2009 Oct 28.

Abstract

Purpose: We have conducted a retrospective, comparative analysis of the accuracy of preoperative diagnosis and frozen section diagnosis relative to postoperative diagnosis.

Methods: Subjects consisted of 168 patients with endometrial cancer, and frozen section was also performed. The diagnostic accuracy and the under-diagnosis rates in regard to both the myometrial invasion (MI) and the histological type and grade (HTG) were determined.

Results: The diagnostic accuracy rate for preoperative HTG and MI were 64.3 and 54.8%, while the under-diagnosis rate was 25.0 and 35.7%. In contrast, the corresponding diagnostic accuracy rate for frozen HTG and MI were 84.5 and 85.7%, while under-diagnosis was 9.5 and 9.5%. Statistical analysis showed that the diagnostic accuracy rate for HTG and MI were significantly higher with frozen section diagnosis than with preoperative diagnosis (P<0.0001) and the under-diagnosis rate for HTG and MI were significantly lower with frozen section diagnosis than with preoperative diagnosis (P<0.0001).

Conclusions: Frozen section diagnosis was clearly more effective than preoperative diagnosis involving MRI as a basis for deciding the operative technique for endometrial cancer.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / pathology*
  • Adult
  • Aged
  • Aged, 80 and over
  • Endometrial Neoplasms / pathology*
  • Female
  • Frozen Sections*
  • Humans
  • Middle Aged
  • Myometrium / pathology*
  • Retrospective Studies