E-ISSN: 2619-9467

Contents    Cover    Publication Date: 08 Jul 2021
Year 2021 - Volume 31 - Issue 2

Open Access

Peer Reviewed

ORIGINAL RESEARCH
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Challenges of Frozen Section in Borderline Ovarian Tumors: A 10-Year Retrospective Analysis from a Tertiary Gynecological Cancer Center: Retrospective Analysis

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J Clin Obstet Gynecol. 2021;31(2):40-5
DOI: 10.5336/jcog.2020-76344
Article Language: EN
Copyright Ⓒ 2024 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: Frozen section procedure gives a great advantage of fertility preserving in young women with borderline ovarian tumors (BOTs). However diagnostic accuracy of frozen section in BOTs is not as high as the other ovarian lesions. In the present study, we aimed to evaluate the comparison of frozen section results and final pathology results in patients with BOTs. Material and Methods: A total of 97 patients who had BOTs, either on the frozen section or final paraffin section in our clinic between 2007 and 2017 were included in the study. Frozen section and final pathology were compared with medical records of the patients such as age, menstruation, preoperative serum CA-125 and CA 19-9 values, histological diagnosis, subtype, size, localization, and capsule involvement. Results: In BOTs, the diagnostic accuracy of the frozen section was 67%. Frozen section has 74% sensitivity, 40% specificity, 83% positive predictive value and 29% negative predictive value. In the present study, the only factor that affects the accordance between the frozen section and the final paraffin section was the papillarity of the tumor, and it was observed that when the tumor was more papillary, the results had been more compatible. Conclusion: In BOTs, surgical management should be performed with caution depending on the frozen section to avoid overtreatment, especially in young women.
REFERENCES:
  1. Seidman JD, Cho KR, Ronnett BM, Kurman RJ. Surface epithelial tumors of the ovary. Blaustein's pathology of the female genital tract: Springer; 2011. p.679-784. [Crossref] 
  2. Skírnisdóttir I, Garmo H, Wilander E, Holmberg L. Borderline ovarian tumors in Sweden 1960-2005: trends in incidence and age at diagnosis compared to ovarian cancer. Int J Cancer. 2008;123(8):1897-901. [Crossref]  [PubMed] 
  3. Mink PJ, Sherman ME, Devesa SS. Incidence patterns of invasive and borderline ovarian tumors among white women and black women in the United States. Results from the SEER Program, 1978-1998. Cancer. 2002;95(11): 2380-9. [Crossref]  [PubMed] 
  4. Hannibal CG, Huusom LD, Kjaerbye-Thygesen A, Tabor A, Kjaer SK. Trends in incidence of borderline ovarian tumors in Denmark 1978-2006. Acta Obstet Gynecol Scand. 2011;90(4):305-12. [Crossref]  [PubMed] 
  5. Guvenal T, Dursun P, Hasdemir PS, Hanhan M, Guven S, Yetimalar H, et al. Effect of surgical staging on 539 patients with borderline ovarian tumors: a Turkish Gynecologic Oncology Group study. Gynecol Oncol. 2013;131(3): 546-50. [Crossref]  [PubMed] 
  6. Lesieur B, Kane A, Duvillard P, Gouy S, Pautier P, Lhommé C, et al. Prognostic value of lymph node involvement in ovarian serous borderline tumors. Am J Obstet Gynecol. 2011;204(5):438.e1-7. [Crossref]  [PubMed] 
  7. Geomini P, Bremer G, Kruitwagen R, Mol BW. Diagnostic accuracy of frozen section diagnosis of the adnexal mass: a metaanalysis. Gynecol Oncol. 2005;96(1):1-9. [Crossref]  [PubMed] 
  8. Harter P, Gershenson D, Lhomme C, Lecuru F, Ledermann J, Provencher DM, et al. Gynecologic Cancer InterGroup (GCIG) consensus review for ovarian tumors of low malignant potential (borderline ovarian tumors). Int J Gynecol Cancer. 2014;24(9 Suppl 3):S5-8. [Crossref]  [PubMed] 
  9. Kayikçioglu F, Pata O, Cengiz S, Tulunay G, Boran N, Yalvaç S, et al. Accuracy of frozen section diagnosis in borderline ovarian malignancy. Gynecol Obstet Invest. 2000;49(3): 187-9. [Crossref]  [PubMed] 
  10. Houck K, Nikrui N, Duska L, Chang Y, Fuller AF, Bell D, et al. Borderline tumors of the ovary: correlation of frozen and permanent histopathologic diagnosis. Obstet Gynecol. 2000;95(6 Pt 1):839-43. [Crossref]  [PubMed] 
  11. Song T, Choi CH, Kim HJ, Kim MK, Kim TJ, Lee JW, et al. Accuracy of frozen section diagnosis of borderline ovarian tumors. Gynecol Oncol. 2011;122(1):127-31. [Crossref]  [PubMed] 
  12. Tempfer CB, Polterauer S, Bentz EK, Reinthaller A, Hefler LA. Accuracy of intraoperative frozen section analysis in borderline tumors of the ovary: a retrospective analysis of 96 cases and review of the literature. Gynecol Oncol. 2007;107(2):248-52. [Crossref]  [PubMed] 
  13. Kim JH, Kim TJ, Park YG, Lee SH, Lee CW, Song MJ, et al. Clinical analysis of intra-operative frozen section proven borderline tumors of the ovary. J Gynecol Oncol. 2009;20(3): 176-80. [Crossref]  [PubMed]  [PMC] 
  14. Menzin AW, Rubin SC, Noumoff JS, LiVolsi VA. The accuracy of a frozen section diagnosis of borderline ovarian malignancy. Gynecol Oncol. 1995;59(2):183-5. [Crossref]  [PubMed] 
  15. Wong HF, Low JJ, Chua Y, Busmanis I, Tay EH, Ho TH. Ovarian tumors of borderline malignancy: a review of 247 patients from 1991 to 2004. Int J Gynecol Cancer. 2007;17(2):342-9. [Crossref]  [PubMed] 
  16. Tropé CG, Kristensen G, Makar A, eds. Surgery for borderline tumor of the ovary. Semin Surg Onco. 2000;19(1):69-75. [Link] 
  17. Brun JL, Cortez A, Rouzier R, Callard P, Bazot M, Uzan S, et al. Factors influencing the use and accuracy of frozen section diagnosis of epithelial ovarian tumors. Am J Obstet Gynecol. 2008;199(3):244.e1-7. [Crossref]  [PubMed]