Comparing the Intraoperative Frozen Section With Permanent Pathology in Assessing the Depth of Myometrial Invasion, Tumor Size, and Histological Subtype and Grade in Endometrial Cancer

Objectives: Endometrial cancer is one of the most important and prevalent malignancies among women and its treatment and prognosis depends on the severity and spread of the disease in the body. The present study aimed to evaluate the accuracy of the frozen section (FS) as a reliable method for intraoperative decision-making in patients with endometrial endometrioid adenocarcinoma. Materials and Methods: This study was conducted during September 2016- February 2017 on 50 patients with endometrioid adenocarcinoma, detected by the diagnostic curettage which was the total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH + BSO) surgery candidate in the oncology ward of Al-Zahra hospital of Tabriz. Tissue samples of TAH + BSO patients sent for FS pathology were evaluated in terms of histological subtype criteria including endometrioid, serous, clear cell, undifferentiated, tumor grade 1, 2, and 3, tumor size in cm smaller or bigger than 2 cm, and myometrial invasion (MI) rate higher or lower than 50 %. FS results were compared to the final results of the paraffin section (PS) pathology. Results: The concordance rate between PS and FS regarding the risk factors of endometrioid (k: 0 .492, P < 0.001), myometrium invasion (k: 0.729, P < 0.001), tumor size (k: 0.800, P < 0.001), tumor grade (k: 0.641, P < 0.001), undifferentiated (k: 0.545, P < 0.001), adenosquamous (k: 0.390, P < 0.005), papillary serous (k: 0.658, P < 0.001), and clear cell (k: 0.479, P < 0.001) was 49, 73, 80, 64, 54, 39, and 65 %, respectively. Conclusions: Based on the results, if FS is accurately and precisely implemented, an appropriate decision can be taken for low-risk patients. This method can successfully be adopted by the gynecologic oncologists.