Frozen Section as an Intraoperative Guide to Tailor Surgical Staging in Early-Stage Endometrial Cancer

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Khalid Atallah ◽  
Basel Refky ◽  
Omar Hamdy ◽  
Gehad Ahmed Saleh ◽  
M. M. A. Zaki ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Early Stage ◽  
Frozen Section ◽  
Surgical Staging ◽  
Early Stage Endometrial Cancer

Intraoperative Frozen Section Risk Assessment Accurately Tailors the Surgical Staging in Patients Affected by Early-Stage Endometrial Cancer: The Application of 2 Different Risk Algorithms

2014 ◽  
Vol 24 (6) ◽  
pp. 1021-1026 ◽  
Author(s):  
Paolo Sala ◽  
Matteo Morotti ◽  
Mario Valenzano Menada ◽  
Elisa Cannavino ◽  
Ilaria Maffeo ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Positive Predictive Value ◽  
Mayo Clinic ◽  
Predictive Value ◽  
Early Stage ◽  
Frozen Section ◽  
Concordance Rate ◽  
Risk Status ◽  
Sensitivity Specificity ◽  
Early Stage Endometrial Cancer

ObjectiveThe aim of this study was to investigate the frozen section (FS) accuracy in tailoring the surgical staging of patients affected by endometrial cancer, using 2 different risk classifications.Methods/MaterialsA retrospective analysis of 331 women affected by type I endometrial cancer and submitted to FS assessment at the time of surgery. Pathologic features were examined on the frozen and permanent sections according to both the GOG33 and the Mayo Clinic algorithms. We compared the 2 models through the determination of Landis and Koch kappa statistics, concordance rate, sensitivity, specificity, positive predictive value, and negative predictive value for each risk algorithm, to assess whether there are differences in FS accuracy depending on the model used.ResultsThe observed agreement between the frozen and permanent sections was respectively good (k = 0.790) for the GOG33 and optimal (k = 0.810) for the Mayo classification. Applying the GOG33 algorithm, 20 patients (6.7%) were moved to an upper risk status, and 20 (6.7%) were moved to a lower risk status on the permanent section; the concordance rate was 86.5%. With the Mayo Clinic algorithm, discordant cases between frozen and permanent sections were 19 (7.6%), and the risk of lymphatic spread was underestimated only in 1 case (0.4%); the concordance rate was 92.4%. The sensitivity, specificity, positive predictive value, and negative predictive value for the GOG33 were 92%, 94%, 92%, and 93%, whereas with the Mayo algorithm, these were 98%, 91%, 77%, and 99%, respectively.ConclusionsAccording to higher correlation rate and observed agreement (92.4% vs 86.5% and k = 0.810 vs 0.790, respectively), the Mayo Clinic algorithm minimizes the number of patients undertreated at the time of surgery than the GOG33 classification and can be adopted as an FS algorithm to tailor the surgical treatment of early-stage endometrial cancer even in different centers.

Frozen Section Underestimates the Need for Surgical Staging in Endometrial Cancer Patients

2009 ◽  
Vol 19 (9) ◽  
pp. 1570-1573 ◽  
Author(s):  
Andrea Papadia ◽  
Guglielmo Azioni ◽  
Bruno Brusacà ◽  
Ezio Fulcheri ◽  
Karen Nishida ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Cancer Patients ◽  
Early Stage ◽  
Frozen Section ◽  
Tumor Grade ◽  
Gynecologic Oncology Group ◽  
Nodal Involvement ◽  
Risk Status ◽  
Intraoperative Frozen Section ◽  
Early Stage Endometrial Cancer

Objective:To compare the risk status for lymph nodal metastasis at frozen section in endometrial cancer by applying a model based on tumor grade and myometrial involvement.Study Design:A retrospective analysis was performed on 174 early-stage endometrial cancer patients on whom an intraoperative frozen section was requested. Patients were retrospectively divided into low, intermediate, and high risk for lymph nodal involvement based on tumor grade and myometrial invasion based on Gynecologic Oncology Group 33 data. Concordance of risk status at frozen and permanent sections was performed.Results:Risk status at frozen and permanent sections were highly correlated (P < 0.01). Agreement between frozen and permanent sections was substantial (κ = 0.625). In 16% of the cases, frozen section underestimated the risk when compared with permanent section.Conclusion:Relying on intraoperative frozen section of the uterus to assess risk status for lymph nodal involvement in early-stage endometrial cancer patients leads to suboptimal management in a substantial number of cases.

EP530 Indocyanine green in surgical staging of early stage endometrial cancer

2019 ◽  
Author(s):  
I Gladchuk ◽  
N Rozhkovska ◽  
V Marichereda ◽  
V Kozhakov ◽  
Y Petrovskiy
Keyword(s):  
Endometrial Cancer ◽  
Indocyanine Green ◽  
Early Stage ◽  
Surgical Staging ◽  
Early Stage Endometrial Cancer
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