A Critical Appraisal of Intraoperative Frozen Section Analysis of Ovarian Tumors: A 3-Year Review of Accuracy and Clinicopathological Correlation at a Tertiary Care Center

Background: Intraoperative frozen section (IFS) plays a pivotal role in arriving at a diagnosis and guiding toward appropriate surgical management as there is a lack of effective ovarian cancer screening methods. Considering histopathology as the gold standard, the current study was conducted to examine the accuracy of frozen section in ovarian tumors.

Materials and methods: A prospective analysis was conducted on 52 cases of IFS of ovarian masses over 3 years (April 2018 to March 2021). Frozen section and permanent paraffin section reports were compared, and overall sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated. The role of various clinicopathological parameters in predicting ovarian malignancy was also evaluated.

Results: The study group included 42 benign, 3 borderline, and 7 malignant tumors, with surface epithelial tumors being the most frequent. Discordance between IFS and histopathological diagnosis was observed in two cases. We observed a high sensitivity (90%), specificity (97%), PPV (90%), NPV (97%), and accuracy (94%) for frozen section of ovarian tumors. CA-125 (P = 0.007) and menopausal status (P = 0.05) emerged as significant for predicting malignancy statistically.

Conclusion: Intraoperative frozen represents that section envisages pathologic examination in a time-bound manner and promotes fruitful communication between clinicians and pathologists, so that appropriate information is shared to curtail errors. Despite the small sample size, this study reiterates that frozen section serves as an effective diagnostic tool for intraoperative evaluation of ovarian masses when utilized judiciously by pathologists and surgeons as the advantages surpass the limitations.