Frozen section accurately allows pathological characterization of endometrial cancer in patients with a preoperative ambiguous or inconclusive diagnoses: our experience

• Published in: BMC cancer Vol. 19; no. 1; p. 1096
• Main Authors: Santoro, A, Piermattei, A, Inzani, F, Angelico, G, Valente, M, Arciuolo, D, Spadola, S, Martini, M, Fanfani, F, Fagotti, A, Gallotta, V, Scambia, G, Zannoni, G F
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 12.11.2019; BioMed Central; BMC
• Subjects: Biopsy; Cancer; Cancer patients; Carcinoma; Care and treatment; Diagnosis; Endometrial cancer; Endometrial carcinoma; Endometrial Neoplasms - diagnosis; Endometrial Neoplasms - surgery; Female; Frozen section; Frozen Sections - methods; Frozen Sections - standards; Humans; Intraoperative Care; Intraoperative surgical staging; Magnetic Resonance Imaging; Medical research; Neoplasm Grading; Neoplasm Invasiveness; Neoplasm Metastasis; Neoplasm Staging; Preoperative Care; Retrospective Studies; Surgery; Tumors; Endometrial carcinoma; Frozen section; Intraoperative surgical staging
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-019-6318-5

The aim of this study was to assess the agreement rate between intraoperative evaluation (IOE) and final diagnosis (FD) in a series of surgically resected endometrial carcinoma (EC), with a preoperative ambiguous or inconclusive diagnosis by endometrial biopsies and imaging. A retrospective study was performed selecting patients who underwent surgery with IOE for suspected EC at our institution from 2012 to 2018. A K coefficient was determined with respect to the histotype, tumor grade, myometrial infiltration and cervical involvement. Data analysis has been performed on 202 women. The IOE evaluation was distributed as Endometrioid (n = 180) and Non-Endometrioid (n = 22). The comparison between the frozen section (FS) and the definitive histological subtype showed an overall agreement rate of 93,07% (k = 0.612) and an agreement of 97.2% for Endometrioid vs 59% for Non-Endometrioid tumors. The FIGO system grading was the same in 91,1% of patients, none was upgraded and in 8,9% downgraded. Observed agreements were 89,11% and 95,54% for myometrial and cervical involvement, respectively. The good agreement between intraoperative grading, myometrial invasion and their histological definition on permanent sections highlights that FS is a good predictor for surgical outcome, in particular in presence of a preoperative ambiguous or inconclusive diagnostic evaluation.