Accuracy and Reproducibility of Frozen Section Diagnosis in Ovarian Tumors: A 10-Year Experience at a Tertiary Cancer Center.
* Context.--Intraoperative consultation--frozen section diagnosis (FSD)--determines tumor pathology and guides the optimal surgical management of ovarian neoplasms intraoperatively. Objective.--To evaluate the diagnostic accuracy of the FSD and analyze the discrepancy between the FSD and final diagn...
| Publicado en: | Archives of Pathology & Laboratory Medicine Vol. 146; no. 5; pp. 626 - 632 |
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| Autores principales: | , , , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
College of American Pathologists
May2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=156555003&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 156555003 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00039985 1FS jtl: Archives of Pathology & Laboratory Medicine issn: 00039985 maglogo: N pubinfo: dt: May2022 vid: 146 iid: 5 pid: 2550 pub: College of American Pathologists place: Northfield, Illinois artinfo: ui: 156555003 156555003 156555003 10.5858/arpa.2020-0686-OA 156555003 ppf: 626 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Accuracy and Reproducibility of Frozen Section Diagnosis in Ovarian Tumors: A 10-Year Experience at a Tertiary Cancer Center. aug: au: Zaiem, Feras Deirawan, Hany Kherallah, Raghad Fehmi, Omar Hyejeong Jang Seongho Kim Bandyopadhyay, Sudeshna Ali-Fehmi, Rouba affil: Departments of Pathology and Gynecologic Oncology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan sug: subj: Ovarian Neoplasms Diagnosis Frozen Sections Tertiary Health Care Cancer Care Facilities Reproducibility of Results Human Female Retrospective Design Record Review Pathologists Ovarian Neoplasms Prognosis Ovarian Neoplasms Mortality Sensitivity and Specificity Descriptive Statistics Female ab: * Context.--Intraoperative consultation--frozen section diagnosis (FSD)--determines tumor pathology and guides the optimal surgical management of ovarian neoplasms intraoperatively. Objective.--To evaluate the diagnostic accuracy of the FSD and analyze the discrepancy between the FSD and final diagnosis. Design.--This is a retrospective study of 618 ovarian neoplasm FSDs from 2009 to 2018 at a tertiary health care center. The discrepant cases were reviewed and reevaluated by gynecologic and general surgical pathologists. The outcomes of interest were performing unnecessary procedure, returning for a second surgery, and 30-day postoperative mortality. Results.--The sensitivity and the positive predictive value of the FSD were lower in borderline tumors than in benign and malignant epithelial ovarian tumors. Major and minor discrepancies were identified in 5.3% (33 of 618) and 12.3% of (76 of 618) cases, respectively. A root cause analysis of the major discrepant cases showed that sampling error accounted for 43% (14 of 33). The discrepancy distributions of gynecologic and general surgical pathologists were statistically similar in the overall cohort (P = .65). The overall j for diagnostic agreement among gynecologic pathologists, general surgical pathologists, and final diagnosis was 0.18 (0.10-0.26, P < .001), implying only a slight overall agreement. Of the major discrepant cases, only 3 had a clinical implication. One overdiagnosed patient underwent an unecessary procedure, and 2 underdiagnosed patients were recommended to return for a second surgery. No patient had 30-day postoperative mortality. Conclusions.--Frozen section diagnosis remains a definitive diagnostic tool in ovarian neoplasms and plays a crucial role in guiding intraoperative surgical management. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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