J Gynecol Oncol.  2019 Nov;30(6):e95. 10.3802/jgo.2019.30.e95.

Accuracy of frozen section diagnosis and factors associated with final pathological diagnosis upgrade of mucinous ovarian tumors

• Park JY
• Lee SH
• Kim KR
• Kim YT
• Nam JH

• KMID: 2458900
• DOI: http://doi.org/10.3802/jgo.2019.30.e95

Abstract

OBJECTIVE
To determine the accuracy of frozen section diagnosis and factors associated with final pathological diagnosis upgrade in patients with mucinous ovarian tumors.
METHODS
This study included 1,032 patients with mucinous ovarian tumors who underwent frozen section diagnosis during surgery. Sensitivity, specificity, and diagnostic accuracy of frozen section diagnosis was calculated. Univariate and multivariate regression analyses were performed to determine factors associated with diagnosis upgrade in the final pathology report.
RESULTS
The sensitivity and specificity of frozen section diagnosis were 99.1% (95% confidence interval [CI]=98%-99.6%) and 82.2% (95% CI=77.9%-85.7%), respectively, for benign mucinous tumors; 74.6% (95% CI=69.1%-79.4%) and 96.7% (95% CI=95.2%-97.8%), respectively, for mucinous borderline ovarian tumors; and 72.5% (95% CI=62.9%-80.3%) and 98.8% (95% CI=97.9%-99.3%), respectively, for invasive mucinous carcinomas. The multivariate analysis revealed that mixed tumor histology (odds ratio [OR]=2.8; 95% CI=1.3-6.3; p=0.012), tumor size >12 cm (OR=2.5; 95% CI=1.5-4.3; p=0.001), multilocular tumor (OR=2.9; 95% CI=1.4-6.0; p=0.006), and presence of a solid component in the tumor (OR=3.1; 95% CI=1.8-5.1; p<0.001) were independent risk factors for final pathological diagnosis upgrade.
CONCLUSIONS
Mixed tumor histology, tumor size >12 cm, multilocular tumor, and presence of a solid component in the tumor were independent risk factors for final pathological diagnosis upgrade based on frozen section diagnosis.

Keyword

Ovarian Neoplasm; Mucinous; Frozen Section; Diagnosis; Accuracy

MeSH Terms

Adenocarcinoma, Mucinous
Diagnosis*
Frozen Sections*
Humans
Mucins*
Multivariate Analysis
Ovarian Neoplasms
Pathology
Risk Factors
Sensitivity and Specificity
Mucins

Figure

• 

  Fig. 1. Study flow chart. AGC, advanced gastric cancer; GB, gallbladder; HCC, hepatocelluar carcinoma; PTC, parathyroid cancer. * Samples were not available for frozen section diagnosis; these cases included 52 patients with unilateral and two patients with bilateral mucinous benign ovarian tumors. In addition, nine patients with bilateral benign mucinous tumors had frozen sections available for only one ovarian tumor.

Reference

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