Feasibility, accuracy and advantages of frozen section examination of ovarian masses with normal tumor markers. A tertiary referral center experience

Abstract

Introduction: Proper design of the operative plan for patients with ovarian masses is a must to avoid unnecessary surgical steps, the need for another surgery or empirical chemotherapy. We investigated the role of frozen section examination in this design. Methods: This was a prospective study in which 64 complex adnexal masses with normal tumor markers underwent frozen section examination. The patients were divided into two parallel groups: group A in which the decision whether to proceed for complete staging or not was built on the result of the examination, and group B in which the patients underwent panhysterectomy at baseline regardless of their frozen section examination result. Postoperative stay, estimated blood loss and the incidence of complications were compared. Results: When comparing the two groups, including patients with tumors that turned out to be benign, there were no significant differences in postoperative complications, but there were for the operative time (60 vs. 120 minutes, p = 0.004) and blood loss, which were significantly lower in group A (50 vs. 100 mL, p = 0.001), and hospital stay, which was statistically insignificantly shorter than in group B (1 day vs. 2 days, p = 0.062). The sensitivity of frozen section examination for benign, borderline, and malignant ovarian masses was 91.9%, 76.9%, 53.3%, respectively, while the specificity was 85.2%, 87.5%, 95.9% and the overall diagnostic accuracy was 89.6%, 85.2%, 85.9%, respectively. Conclusion: The use of frozen section examination in the assessment of complex ovarian masses in patients with normal tumor markers offers an acceptable accuracy with a significant decrease of the operative time, blood loss as well as hospital stay.