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- DOI 10.18231/j.ijpo.2025.029
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CrossMark
Intraoperative frozen section study of ovarian tumours
- Author Details:
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Priya Garg
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Sheeladevi Chandakavadi Shivalingaiah
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Deepika Gurumurthy *
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Shashirekha Basavaraju
Priya Garg
Sheeladevi Chandakavadi Shivalingaiah
Deepika Gurumurthy *
Shashirekha Basavaraju
Background: Ovarian neoplasms are a heterogenous group of tumours with diverse treatment for different tumours. Intraoperative frozen section (IFS) is an important diagnostic tool for differentiating benign from malignant ovarian tumours. The precision of diagnosis of ovarian neoplasms by frozen section was observed to vary in various studies and this study attempts to evaluate the diagnostic accuracy of IFS in identifying different ovarian tumours. It helps in guiding the optimal surgical procedure in the management.
Aim and Objective: This study aims to assess the diagnostic performance of IFS in the diagnosis of various ovarian tumours.
Materials and Methods: A retrospective study was undertaken between 2015 to 2020. Sensitivity, specificity and accuracy of IFS were calculated. In discordant cases, the slides were re-evaluated to determine the possible factors for erroneous diagnosis.
Results: Out of 95 cases, majority were epithelial tumours which accounted 87.3%. The diagnostic accuracy was 88.4% and the sensitivity of IFS was 67.9%, 53.85% and 100% for malignant, borderline and benign tumours respectively. The corresponding specificity was 91.04%, 97.56% and 95.9%. All the germ cell tumours were accurately diagnosed. The sensitivity and specificity for sex cord stromal tumours was 100% and 96.6% respectively. The IFS and formalin sections had an 88.4% concordance.
Conclusion: IFS is a reliable technique in the evaluation of patients with ovarian neoplasms. It is most valuable for high accuracy and specificity in diagnosis of ovarian malignancies but caution must be taken when dealing with borderline malignancies. Pathologists should be aware of the pitfalls to avoid inappropriate surgery.
Keywords: Intraoperative Frozen section; Ovarian neoplasms; Diagnostic accuracy
References
- Arora RS, Patel SM, Dave PS, Patel B, Parikh CD, Poddar P. Role of Intraoperative Frozen Section in the Diagnosis of Ovarian Tumors: Experience at Gujarat Cancer and Research Institute. Indian J Gynecol Oncolog. 2018;16:63.
- Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209–49.
- Mathur P, Sathishkumar K, Chaturvedi M, Das P, Sudarshan KL, Santhappan S, et al. Cancer Statistics, 2020: Report From National Cancer Registry Programme, India. JCO Global Oncol. 2020;6(6):1063–75.
- Bige O, Demir AD, Saygili U, Gode F, Uslu T, Koyuncuoglu M. Frozen section diagnoses of 578 ovarian tumors made by pathologists with and without expertise on gynecologic pathology. Gynecol Oncol. 2011;123(1):43–6.
- Augestine T, Palakkan S, Valsan M, Vahab KA, Nair L. Role of frozen section in surgical management of ovarian neoplasm. Gynecol Minim Invasive Ther. 2020;9(1):13–7.
- Ganesan R, Brown LJR, Kehoe S, McCluggage WG, El-Bahrawy MA. The role of frozen sections in gynaecological oncology: survey of practice in the United Kingdom. Eur J Obstet Gynecol Reprod Biol. 2012;166(2):204–8.
- Kung FY, Tsang AK, Yu EL. Intraoperative frozen section analysis of ovarian tumors: a 11-year review of accuracy with clinicopathological correlation in a Hong Kong Regional hospital. Int J Gynecol Cancer. 2019;29(4):772–8.
- Lokuhetty D, White VA, Watanabe R. WHO Classification of Female Genital Tumors, 5th edn. Internal Agency for Research on Cancer (IARC) Female genital Tumours, Lyon. 2020
- Shreffler J, Huecker MR. Diagnostic Testing Accuracy: Sensitivity, Specificity, Predictive Values and Likelihood Ratios. In: StatPearls. StatPearls Publishing, Treasure Island (FL);2020.
- Shahmoradi F, Arab M. Diagnostic Accuracy Value of Intraoperative Frozen Section for Ovarian Neoplasms. Indian J Gynecol Oncolog. 2020;18:76.
- Yazdani S, Bouzari Z, Abedisamakoush M, Sharbatdaran M. Accuracy of intra-operative frozen section in the diagnosis of ovarian mass. Caspian J Reprod Med. 2015:1(3):7–11.
- Arshad NZM, Ng BK, Paiman NAM, Mahdy ZA, Noor RM. Intra- Operative Frozen Sections for Ovarian Tumors – A Tertiary Center Experience. Asian Pac J Cancer Prev. 2018;19(1):213–18.
- Hashmi AA, Naz S, Edhi MM, Faridi N, Hussain SD, Mumtaz S, et al. Accuracy of intraoperative frozen section for the evaluation of ovarian neoplasms: an institutional experience. World J Surg Oncol. 2016;14:91.
- Yoshida H, Tanaka H, Tsukada T, Abeto N, Kobayashi-Kato M, Tanase Y, et al. Diagnostic Discordance in Intraoperative Frozen Section Diagnosis of Ovarian Tumors: A Literature Review and Analysis of 871 Cases Treated at a Japanese Cancer Center. Int J SurgPathol. 2021;29(1):30–8.
- Mukherjee T, Mukherjee S, Sanyal P, Bharadwaj V, Sampath S, Gunjan. Correlation of biomarkers and frozen section diagnosis with paraffin histopathological diagnosis in suspected ovarian cancer. Int J MolImmuno Oncol. 2019;4(3):67–71.
- Morton R, Anderson L, Carter J, Pather S, Saidi SA. Intraoperative Frozen Section of Ovarian Tumors: A 6-Year Review of Performance and Potential Pitfalls in an Australian Tertiary Referral Center. Int J Gynecol Cancer. 2017;27(1):17–21.
- Ratnavelu ND, Brown AP, Mallett S, Scholten RJ, Patel A, Founta C, et al. Intraoperative frozen section analysis for the diagnosis of early stage ovarian cancer in suspicious pelvic masses. Cochrane Database Syst Rev. 2016;3(3):CD010360.
- Açikalin A, Torun G, Bağir E, Bayram F, Zeren H, Gulec U, et al. Intraoperative frozen section in ovarian neoplasms; a tertiary centre experience. Turk Patoloji Derg. 2014;30(3):184–8.
- Gultekin E, Gultekin OE, Cingillioglu B, Sayhan S, Sanci M, Yildirim Y. The value of frozen section evaluation in the management of borderline ovarian tumors. J Cancer Res Ther. 2011;7(4):416–20.
- Pongsuvareeyakul T, Khunamornpong S, Settakorn J, Sukpan K, Suprasert P, Siriaunkgul S. Accuracy of frozen-section diagnosis of ovarian mucinous tumors. Int J Gynecol Cancer. 2012;22(3):400–6.