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Ovarian tumor frozen section, a multidisciplinary affair

Asp, Mihaela LU orcid ; Peber, Ebba ; Kannisto, Päivi LU ; Måsbäck, Anna LU and Malander, Susanne LU orcid (2022) In Acta Oncologica 61(7). p.785-792
Abstract
Background
Ovarian Cancer (OC) constitute the eighth most common cancers among women worldwide. Surgery remains the cornerstone in the management of OC. Intraoperative frozen section (FS) diagnosis is widely used to decide the surgery course. We aimed to assess the reliability of intraoperative FS diagnosis for treatment planning of patients with suspected OC from a multidisciplinary perspective. The clinical consequences of reclassification and the multidisciplinary management of the therapy plan, is the secondary aim of this study. To our knowledge, this information is sparely investigated.
Methods
A single-center, retrospective population-based study of patients who underwent surgery for suspected OC between 2018 and 2020.... (More)
Background
Ovarian Cancer (OC) constitute the eighth most common cancers among women worldwide. Surgery remains the cornerstone in the management of OC. Intraoperative frozen section (FS) diagnosis is widely used to decide the surgery course. We aimed to assess the reliability of intraoperative FS diagnosis for treatment planning of patients with suspected OC from a multidisciplinary perspective. The clinical consequences of reclassification and the multidisciplinary management of the therapy plan, is the secondary aim of this study. To our knowledge, this information is sparely investigated.
Methods
A single-center, retrospective population-based study of patients who underwent surgery for suspected OC between 2018 and 2020. Histopathological outcomes were classified as benign, borderline, or malignant. The FS diagnosis was the diagnostic test, and the final histopathology report was the gold standard. Diagnostic capability for treatment planning was assessed, and modifications made possible by overall clinical knowledge were discussed.
Results
A total of 358 patients were identified, of whom 187 were included in the FS group. Overall accuracy was 89.8%, and 19 patients were reclassified; the malignancy grade of 15 tumors was underestimated. Prevalence, sensitivity, specificity, positive predictive value, and negative predictive value for invasive malignancies on FS were 54.0% (CI 46.6–61.3%), 88.1% (CI 80.2–93.7%), 98.8% (CI 93.7–99.9%), 98.9% (CI 92.7–99.8%), and 87.6% (CI 80.6–92.4%), respectively. Tumors incorrectly graded by FS tended to be of borderline-related.
Conclusions
The reliability of the FS methodology was an accurate test to help perform appropriate surgery and plan swift oncological treatment. FS is a reliable method to diagnose invasive malignancies and benign pathology. The communication between the pathologist, surgeon, and medical oncologist is highly important for both intraoperative decision-making and postoperative patient care. (Less)
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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Accuracy, borderline tumors, A frozen section, ovarian cancer, Multidisciplinary
in
Acta Oncologica
volume
61
issue
7
pages
785 - 792
publisher
Taylor & Francis
external identifiers
  • scopus:85131079991
  • pmid:35611589
ISSN
1651-226X
DOI
10.1080/0284186X.2022.2076257
language
English
LU publication?
yes
id
d125eb27-fd8b-4c11-973f-0fdb9de5e328
date added to LUP
2022-05-26 00:17:11
date last changed
2022-11-09 01:20:10
@article{d125eb27-fd8b-4c11-973f-0fdb9de5e328,
  abstract     = {{Background<br/>Ovarian Cancer (OC) constitute the eighth most common cancers among women worldwide. Surgery remains the cornerstone in the management of OC. Intraoperative frozen section (FS) diagnosis is widely used to decide the surgery course. We aimed to assess the reliability of intraoperative FS diagnosis for treatment planning of patients with suspected OC from a multidisciplinary perspective. The clinical consequences of reclassification and the multidisciplinary management of the therapy plan, is the secondary aim of this study. To our knowledge, this information is sparely investigated.<br/>Methods<br/>A single-center, retrospective population-based study of patients who underwent surgery for suspected OC between 2018 and 2020. Histopathological outcomes were classified as benign, borderline, or malignant. The FS diagnosis was the diagnostic test, and the final histopathology report was the gold standard. Diagnostic capability for treatment planning was assessed, and modifications made possible by overall clinical knowledge were discussed.<br/>Results<br/>A total of 358 patients were identified, of whom 187 were included in the FS group. Overall accuracy was 89.8%, and 19 patients were reclassified; the malignancy grade of 15 tumors was underestimated. Prevalence, sensitivity, specificity, positive predictive value, and negative predictive value for invasive malignancies on FS were 54.0% (CI 46.6–61.3%), 88.1% (CI 80.2–93.7%), 98.8% (CI 93.7–99.9%), 98.9% (CI 92.7–99.8%), and 87.6% (CI 80.6–92.4%), respectively. Tumors incorrectly graded by FS tended to be of borderline-related.<br/>Conclusions<br/>The reliability of the FS methodology was an accurate test to help perform appropriate surgery and plan swift oncological treatment. FS is a reliable method to diagnose invasive malignancies and benign pathology. The communication between the pathologist, surgeon, and medical oncologist is highly important for both intraoperative decision-making and postoperative patient care.}},
  author       = {{Asp, Mihaela and Peber, Ebba and Kannisto, Päivi and Måsbäck, Anna and Malander, Susanne}},
  issn         = {{1651-226X}},
  keywords     = {{Accuracy; borderline tumors; A frozen section; ovarian cancer; Multidisciplinary}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{7}},
  pages        = {{785--792}},
  publisher    = {{Taylor & Francis}},
  series       = {{Acta Oncologica}},
  title        = {{Ovarian tumor frozen section, a multidisciplinary affair}},
  url          = {{http://dx.doi.org/10.1080/0284186X.2022.2076257}},
  doi          = {{10.1080/0284186X.2022.2076257}},
  volume       = {{61}},
  year         = {{2022}},
}