|Comparison of Intraoperative Frozen Section with Permanent Pathology in Assessment of Depth of Myometrial Invasion, Tumor Size and Histological Subtype And Grade In Endometrial Cancer|
|Mehri jafari Shobeiri1, Noushin Mobaraki Asl1, Ali Dastranj Tabrizi1, Heidar Ali Esmaeeli2, Manizheh Sayyah-Melli1, Parvin Mostafa-Gharabaghi1, Elaheh Ouladsahebmadarek1, Maryam Vaezi1|
|1Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
2Department of Pathology, Tabriz University of Medical Sciences, Tabriz, Iran
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Keywords : Endometrial cancer, Frozen section, Paraffin section, Surgical staging
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Objectives:Endometrial cancer is one of the most important and prevalent malignancies among women and its treatment and prognosis depends on severity and spread of the disease in body. The purpose of the present study was to evaluate the accuracy of frozen section as a reliable method for intraoperative decision-making in patients with endometrial endometrioid adenocarcinoma.
Materials and Methods:This study was conducted from September 2016 to February 2017on 50 patients with endometrioidadenocarcinoma, diagnosis detected by diagnostic curettage who was total abdominal hysterectomy and bilateral salpingo – oophorectomy(TAH+BSO)surgery candidate in the oncology ward of Al-Zahra Hospital. Tissue samples of TAH+BSO patients sent for frozen section(FS) pathology were evaluated in terms of histological subtype criteria including endometrioid, serous, clear cell, undifferentiated, tumor grade 1, 2 and 3, tumor size in cm smaller than 2 cm,bigger than 2 cm and myometrial invasion rate higher or lower than 50 percent. Frozen section results were compared to final results of paraffin section(PS)pathology.
Results:The concordance rate between paraffin section and frozen section on the risk factors endometrioid (k:0.492, p<0.001), myometrium invasion (k:0.729, p<0.001), tumor size (k:0.800,p<0.001), tumor grade(k:0.641, p<0.001), undifferentiated (k:0.545,p<0.001), adenosquamous (k:0.390, p<0.005), papillaryserous(k:0.658,p<0.001), and clear cell (k:0.479, p<0.001) was 49%, 73%, 80%, 64%, 54%, 39%, and 65% respectively.
Conclusion:Results show that if frozen section is implemented accurately and precisely, an appropriate decision can be taken for low-risk patients. This method can be adopted successfully by gynecologic oncologists.
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