Download PDF
CC BY-NC-ND 4.0 · South Asian J Cancer
DOI: 10.1055/s-0044-1786797
Original Article

Diagnostic Accuracy of Frozen Section Analysis and Factors Associated with Discordance of Final Histopathology in Mucinous Ovarian Tumor

Rubi Gupta
1   Department of Gynaecological Oncology, Gujarat Cancer & Research Institute, Ahmedabad, Gujarat, India
,
Bijal Patel
1   Department of Gynaecological Oncology, Gujarat Cancer & Research Institute, Ahmedabad, Gujarat, India
,
Pariseema Dave
1   Department of Gynaecological Oncology, Gujarat Cancer & Research Institute, Ahmedabad, Gujarat, India
,
Ruchi Arora
1   Department of Gynaecological Oncology, Gujarat Cancer & Research Institute, Ahmedabad, Gujarat, India
,
Chetna Parekh
1   Department of Gynaecological Oncology, Gujarat Cancer & Research Institute, Ahmedabad, Gujarat, India
,
Swetha Dama
1   Department of Gynaecological Oncology, Gujarat Cancer & Research Institute, Ahmedabad, Gujarat, India
› Author Affiliations Funding None.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Zoom Image
Rubi Gupta

Aim and Objective This article determines the diagnostic accuracy of frozen section (FS) in case of mucinous ovarian tumor (MOT) and tailoring of intraoperative treatment decision.

Material and Methods This was an observational study in which retrospective data was analyzed prospectively from January 2008 to December 2015 at the Regional Cancer Center. This study included 158 patients with MOT who underwent FS analysis during staging laparotomy at our institute. FS's sensitivity, specificity, and diagnostic accuracy were calculated and compared with final paraffin histopathological examination (HPE). Univariate and multivariate analyses were done to decide factors associated with changes in final HPE.

Results FS analysis and final HPE report were concordant in 77.8% (123/158) of the cases and discordant in 22.1% (35/158). Out of 35 discordant cases, 29 (18.3%) were upgraded and 06 (5.6%) were downgraded. Out of 33 borderline cases, 16 (48.4%) were upgraded to malignant MOT and 6 (18.1%) were downgraded to benign MOT on final HPE. Out of 40 malignant MOT, 40 (100%) showed malignancy on final HPE. In the case of benign MOT on FS, 13 out of 85 (15.2%) upgraded to borderline or malignant. Sensitivity and specificity of FS were 76.60 and 55.17%, respectively, for benign MOT, 55.17 and 86.96% for borderline MOT, and 86.96 and 100% for malignant MOT.

Conclusion In MOT, due to its large size and heterogeneous nature, it displays spectrum of appearance ranging from benign cyst adenoma, and borderline tumor to adenocarcinoma. Our study showed significant discordance between FS and final histopathological diagnosis in borderline MOT.

Keywords

mucinous ovarian tumor - frozen section - sensitivity - specificity


Publication History

Received: 17 July 2023

Accepted: 02 April 2024

Article published online:
07 May 2024

© 2024. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin 2019; 69 (01) 7-34
    CrossrefPubMedGoogle Scholar
  • 2 Jayson GC, Kohn EC, Kitchener HC, Ledermann JA. Ovarian cancer. Lancet 2014; 384 (9951): 1376-1388
    CrossrefPubMedGoogle Scholar
  • 3 Seidman JD, Kurman RJ, Ronnett BM. Primary and metastatic mucinous adenocarcinomas in the ovaries: incidence in routine practice with a new approach to improve intraoperative diagnosis. Am J Surg Pathol 2003; 27 (07) 985-993
    CrossrefPubMedGoogle Scholar
  • 4 Hata K, Hata T, Manabe A, Kitao M. Ovarian tumors of low malignant potential: transvaginal Doppler ultrasound features. Gynecol Oncol 1992; 45 (03) 259-264
    CrossrefPubMedGoogle Scholar
  • 5 Gotlieb WH, Soriano D, Achiron R. et al. CA 125 measurement and ultrasonography in borderline tumors of the ovary. Am J Obstet Gynecol 2000; 183 (03) 541-546
    CrossrefPubMedGoogle Scholar
  • 6 Twaalfhoven FC, Peters AA, Trimbos JB, Hermans J, Fleuren GJ. The accuracy of frozen section diagnosis of ovarian tumors. Gynecol Oncol 1991; 41 (03) 189-192
    CrossrefPubMedGoogle Scholar
  • 7 Brun JL, Cortez A, Rouzier R. et al. Factors influencing the use and accuracy of frozen section diagnosis of epithelial ovarian tumors. Am J Obstet Gynecol 2008; 199 (03) 244.e1-244.e7
    CrossrefPubMedGoogle Scholar
  • 8 Houck K, Nikrui N, Duska L. et al. Borderline tumors of the ovary: correlation of frozen and permanent histopathologic diagnosis. Obstet Gynecol 2000; 95 (6 Pt 1): 839-843
    PubMedGoogle Scholar
  • 9 Storms AA, Sukumvanich P, Monaco SE. et al. Mucinous tumors of the ovary: diagnostic challenges at frozen section and clinical implications. Gynecol Oncol 2012; 125 (01) 75-79
    CrossrefPubMedGoogle Scholar
  • 10 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 (03) 400-406
    CrossrefPubMedGoogle Scholar
  • 11 Ratnavelu NDG, Brown AP, Mallett S. et al. Intraoperative frozen section analysis for the diagnosis of early stage ovarian cancer in suspicious pelvic masses. Cochrane Database Syst Rev 2016; 3 (03) CD010360
    PubMedGoogle Scholar