Frozen section underestimates the need for surgical staging in endometrial cancer patients.

Andrea Papadia, Guglielmo Azioni, Bruno Brusacà, Ezio Fulcheri, Karen Nishida, Stefania Menoni, Fiona Simpkins, Joseph A. Lucci, Nicola Ragni

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

OBJECTIVE: To compare the risk status for lymph nodal metastasis at frozen section in endometrial cancer by applying a model based on tumor grade and myometrial involvement. STUDY DESIGN: A retrospective analysis was performed on 174 early-stage endometrial cancer patients on whom an intraoperative frozen section was requested. Patients were retrospectively divided into low, intermediate, and high risk for lymph nodal involvement based on tumor grade and myometrial invasion based on Gynecologic Oncology Group 33 data. Concordance of risk status at frozen and permanent sections was performed. RESULTS: Risk status at frozen and permanent sections were highly correlated (P < 0.01). Agreement between frozen and permanent sections was substantial (kappa = 0.625). In 16% of the cases, frozen section underestimated the risk when compared with permanent section. CONCLUSION: Relying on intraoperative frozen section of the uterus to assess risk status for lymph nodal involvement in early-stage endometrial cancer patients leads to suboptimal management in a substantial number of cases.

Original languageEnglish
Pages (from-to)1570-1573
Number of pages4
JournalInternational journal of gynecological cancer : official journal of the International Gynecological Cancer Society
Volume19
Issue number9
StatePublished - Dec 1 2009
Externally publishedYes

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Frozen Sections
Endometrial Neoplasms
Lymph
Uterus
Neoplasms
Neoplasm Metastasis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Frozen section underestimates the need for surgical staging in endometrial cancer patients. / Papadia, Andrea; Azioni, Guglielmo; Brusacà, Bruno; Fulcheri, Ezio; Nishida, Karen; Menoni, Stefania; Simpkins, Fiona; Lucci, Joseph A.; Ragni, Nicola.

In: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, Vol. 19, No. 9, 01.12.2009, p. 1570-1573.

Research output: Contribution to journalArticle

Papadia, A, Azioni, G, Brusacà, B, Fulcheri, E, Nishida, K, Menoni, S, Simpkins, F, Lucci, JA & Ragni, N 2009, 'Frozen section underestimates the need for surgical staging in endometrial cancer patients.', International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, vol. 19, no. 9, pp. 1570-1573.
Papadia, Andrea ; Azioni, Guglielmo ; Brusacà, Bruno ; Fulcheri, Ezio ; Nishida, Karen ; Menoni, Stefania ; Simpkins, Fiona ; Lucci, Joseph A. ; Ragni, Nicola. / Frozen section underestimates the need for surgical staging in endometrial cancer patients. In: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. 2009 ; Vol. 19, No. 9. pp. 1570-1573.
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abstract = "OBJECTIVE: To compare the risk status for lymph nodal metastasis at frozen section in endometrial cancer by applying a model based on tumor grade and myometrial involvement. STUDY DESIGN: A retrospective analysis was performed on 174 early-stage endometrial cancer patients on whom an intraoperative frozen section was requested. Patients were retrospectively divided into low, intermediate, and high risk for lymph nodal involvement based on tumor grade and myometrial invasion based on Gynecologic Oncology Group 33 data. Concordance of risk status at frozen and permanent sections was performed. RESULTS: Risk status at frozen and permanent sections were highly correlated (P < 0.01). Agreement between frozen and permanent sections was substantial (kappa = 0.625). In 16{\%} of the cases, frozen section underestimated the risk when compared with permanent section. CONCLUSION: Relying on intraoperative frozen section of the uterus to assess risk status for lymph nodal involvement in early-stage endometrial cancer patients leads to suboptimal management in a substantial number of cases.",
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AU - Papadia, Andrea

AU - Azioni, Guglielmo

AU - Brusacà, Bruno

AU - Fulcheri, Ezio

AU - Nishida, Karen

AU - Menoni, Stefania

AU - Simpkins, Fiona

AU - Lucci, Joseph A.

AU - Ragni, Nicola

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N2 - OBJECTIVE: To compare the risk status for lymph nodal metastasis at frozen section in endometrial cancer by applying a model based on tumor grade and myometrial involvement. STUDY DESIGN: A retrospective analysis was performed on 174 early-stage endometrial cancer patients on whom an intraoperative frozen section was requested. Patients were retrospectively divided into low, intermediate, and high risk for lymph nodal involvement based on tumor grade and myometrial invasion based on Gynecologic Oncology Group 33 data. Concordance of risk status at frozen and permanent sections was performed. RESULTS: Risk status at frozen and permanent sections were highly correlated (P < 0.01). Agreement between frozen and permanent sections was substantial (kappa = 0.625). In 16% of the cases, frozen section underestimated the risk when compared with permanent section. CONCLUSION: Relying on intraoperative frozen section of the uterus to assess risk status for lymph nodal involvement in early-stage endometrial cancer patients leads to suboptimal management in a substantial number of cases.

AB - OBJECTIVE: To compare the risk status for lymph nodal metastasis at frozen section in endometrial cancer by applying a model based on tumor grade and myometrial involvement. STUDY DESIGN: A retrospective analysis was performed on 174 early-stage endometrial cancer patients on whom an intraoperative frozen section was requested. Patients were retrospectively divided into low, intermediate, and high risk for lymph nodal involvement based on tumor grade and myometrial invasion based on Gynecologic Oncology Group 33 data. Concordance of risk status at frozen and permanent sections was performed. RESULTS: Risk status at frozen and permanent sections were highly correlated (P < 0.01). Agreement between frozen and permanent sections was substantial (kappa = 0.625). In 16% of the cases, frozen section underestimated the risk when compared with permanent section. CONCLUSION: Relying on intraoperative frozen section of the uterus to assess risk status for lymph nodal involvement in early-stage endometrial cancer patients leads to suboptimal management in a substantial number of cases.

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