Diagnostic Accuracy Value of Intraoperative Frozen Section for Ovarian Neoplasms
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ORIGINAL ARTICLE
Diagnostic Accuracy Value of Intraoperative Frozen Section for Ovarian Neoplasms Farinaz Shahmoradi1 • Maliheh Arab2 Received: 14 April 2020 / Revised: 2 June 2020 / Accepted: 12 June 2020 Ó Association of Gynecologic Oncologists of India 2020
Abstract Purpose Accuracy of intraoperative frozen section diagnosis is extremely important in the evaluation of ovarian tumors so that suitable surgical procedures can be chosen. Therefore, the current study was aimed at measuring the diagnostic accuracy of the intraoperative frozen section to determine the surgical course of tumors. Methods This retrospective diagnostic accuracy study was conducted in the Department of Obstetrics and Gynecology, Emam Hossein Hospital. The case records of patients with ovarian mass who underwent surgery and intraoperatively frozen section assessments between September 2006 and December 2014 were analyzed. Demographic and clinical data, operative details, frozen section, and final histopathology examination were reviewed from the medical records. Results One hundred and ninety-three patients with ovarian masses undergoing surgery and frozen section were included. The frozen section diagnoses were benign in 155 (80.31%), borderline in 10 (5.18%), and malignant in 28 (14.51%), whereas the final diagnosis was benign in 154 (79.80%), borderline in 9 (4.66%), and malignant in 30 (15.54%). The overall accuracy of intraoperative frozen section diagnosis was 98.9%. The sensitivity for frozen section diagnosis was 100% for benign, 89% for borderline, and 93.3% for malignant category, whereas the specificity was 97%, 99%, and 100%, respectively. There were three cases with discordance between the frozen section diagnoses and the final diagnoses, all of which were under-diagnosed by frozen section. Conclusion Frozen section was found to be accurate and useful in the intraoperative assessment of patients with ovarian neoplasm. The results may help to determine the type and extent of surgery. Keywords Frozen section Ovarian neoplasms Ovary Diagnostic test Sensitivity
Introduction Ovarian neoplasms are a significant cause of female morbidity and mortality [1]. Ovarian malignancy accounts for nearly 25% of gynecological cancers and 50% of all deaths from female genital cancers [2]. It is one of the top 10 cancers in the USA with an estimated 22,530 new cases and 13,980 deaths in 2019 [3].
& Maliheh Arab [email protected] 1
Obstetrician & Gynecologist, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran
2
Professor of Gyneco-Oncology, Cancer Research Center, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran
Ovarian tumor is frequently diagnosed in females of all ages, including reproductive age groups. Such women had about 10% need for surgery, and about 13–21% were diagnosed with malignant ovarian tumor in those who underwent surgery [4]. Malignancy diagnosis is generally simple, but in some cases it may be hard to differentiate between the ovarian origin of the mal
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