The Role of Frozen Section in Surgical Staging of Low Risk Endometrial Cancer
Author Information
Author(s): Kumar Sanjeev, Bandyopadhyay Sudeshna, Semaan Assaad, Shah Jay P., Mahdi Haider, Morris Robert, Munkarah Adnan, Ali-Fehmi Rouba
Primary Institution: Wayne State University
Hypothesis
What is the agreement rate between frozen section and paraffin section in surgical staging of low risk endometrial cancer?
Conclusion
A significant number of patients with low risk endometrial cancer by frozen section were upstaged and upgraded on final pathology.
Supporting Evidence
- 35% of frozen section results disagreed with permanent section for tumor grade.
- 28% disagreement for depth of myometrial invasion.
- 13% disagreement for cervical involvement.
- 32% disagreement for lymphovascular invasion.
- 31.9% of patients were upstaged on final pathology.
Takeaway
Doctors use a quick test called frozen section during surgery to check for cancer, but it can sometimes give the wrong results, leading to patients not getting the right treatment.
Methodology
This study is a retrospective analysis comparing frozen section results with final pathology in patients diagnosed with low risk endometrial cancer.
Potential Biases
Potential bias minimized by having a gynecologic pathologist review the frozen section slides without knowledge of final outcomes.
Limitations
The study is retrospective and has a limited number of patients.
Participant Demographics
Median age of participants was 60 years, with a range from 24 to 88 years.
Statistical Information
P-Value
p=0.003 for grade disagreement, p<0.0001 for depth of myometrial invasion, p=0.002 for cervical involvement, p=0.01 for lymphovascular invasion.
Confidence Interval
95%CI 0.51–0.68 for grade, 95%CI 0.53–0.69 for myometrial invasion, 95%CI 0.65–0.91 for cervical involvement, 95%CI 0.52–0.69 for lymphovascular invasion.
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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