Abstract | OBJECTIVES: Pathologic intraoperative consultation (IOC) is a common approach for segregating the subset of patients with endometrial cancer who likely require a lymphadenectomy. METHODS: We evaluate factors related to the performance and value of IOC, including the accuracy of frozen sections, "gross-only examinations," and obtaining random sections when a gross lesion is not apparent. RESULTS: IOC was performed by gross examination only in 17 (8%) of 250 cases, the specificity and negative predictive value of which in diagnosing cancer were 100% and 85%, respectively. Among the 64 cases wherein a gross lesion was not apparent and random sections were examined, a final diagnosis of carcinoma was rendered in 20, of which only three (15%) had a diagnosable malignancy on the random section. The frozen-section/final diagnosis concordance was 80% for tumor grade. Determining the depth of myometrial invasion was problematic, with 36% underestimation and 2.6% overestimation. CONCLUSIONS: Obtaining random sections in the absence of a gross lesion has no significant benefit, and a negative result is likely to provide inaccurate data to the surgeon. Frozen-section analyses are a generally reliable tool to determine "low-risk" pathologic parameters that were evaluated herein when a gross lesion is present.
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Authors | Mohamed Mokhtar Desouki, Zaibo Li, Omar Hameed, Oluwole Fadare |
Journal | American journal of clinical pathology
(Am J Clin Pathol)
Vol. 148
Issue 4
Pg. 345-353
(Oct 01 2017)
ISSN: 1943-7722 [Electronic] England |
PMID | 28967955
(Publication Type: Journal Article, Multicenter Study)
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Copyright | © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: [email protected] |
Topics |
- Endometrial Neoplasms
(diagnosis, pathology, surgery)
- Female
- Frozen Sections
- Humans
- Hysterectomy
- Intraoperative Period
- Pathology, Surgical
(methods)
- Predictive Value of Tests
- Referral and Consultation
- Retrospective Studies
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