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

Abstract

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.