Comparative study of Intraoperative Frozen section and Histopathological examination in Surface Epithelial Ovarian Tumors : Retrospective study of 2 years at Tertiary Cancer Care Centre.

Dr. Dhaval Jetly; Dr. Siddharth Thummar; Dr. Neha Nagrani

Volume : VIII, Issue : II, February - 2019

Comparative study of Intraoperative Frozen section and Histopathological examination in Surface Epithelial Ovarian Tumors : Retrospective study of 2 years at Tertiary Cancer Care Centre.

Dr. Dhaval Jetly, Dr. Siddharth Thummar, Dr. Neha Nagrani

Abstract :

Ovarian cancer is the third leading site of cancer among women, trailing behind cervix and east cancer. Surface epithelial ovarian tumors account for approximately two thirds of all ovarian neoplasm. Ovarian tumors represent the most common request site for Frozen Section in gynaecological surgery to determine status of malignancy. Thus extent of surgery is influenced by frozen section.

Frozen Section has a reasonably high sensitivity and specificity in reliable hands. However, studies have demonstrated limited accuracy of Frozen section diagnosis in borderline malignancies. Hence it is important for the pathologist as well as the surgeons to be aware of its limitations along with its advantages.

The present Study aimed to compare the Frozen Section diagnoses with Paraffin Section diagnoses in Surface Epithelial Ovarian Tumors and evaluate the Accuracy of Frozen Section diagnosis. The overall �concordance� between frozen section diagnosis and permanent histopathology report was determined. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of frozen section analysis for benign, borderline and malignant surface epithelial ovarian tumors were evaluated by 2×2 contingency tables.

Our study confirms that the accuracy, sensitivity and specificity of frozen–section diagnosis are high for benign and malignant surface epithelial ovarian tumors whereas it is low for borderline tumors. Borderline tumors remain difficult to be accurately diagnosed at frozen section and requires extensive sampling. The main causes of under–diagnosis in our study are limitation in sampling, tumour heterogeneity and mucinous histology. Frozen section will remain a time tested diagnostic tool so long as surgeries are performed. However, this tool must be judiciously utilized and is most effective when the pathologist and the surgeon are aware of its advantages and limitations.