Role of frozen section in the intraoperative management of ovarian masses

ObjectiveTo evaluate the performance and limitations of FS in the intraoperative evaluation of ovarian masses.DesignRetrospective descriptive study.MethodsThe case records of patients presenting with ovarian masses who underwent surgery and intraoperative FS assessment between January 2009 and December 2012 were analyzed. Demographic and clinical data were reviewed. Data on FS analysis were compared with the final diagnosis on paraffin section.ResultsSixty patients with ovarian masses undergoing surgery and FS were included. Four cases had the diagnosis at the time of FS deferred (6.6%). In the remaining 56 patients, the FS diagnoses were benign in 24 (40%), borderline in 9 (15%), and malignant in 23 (38.4%), whereas the final diagnosis was benign in 23 (38.4%), borderline in 11 (18.3%), and malignant in 26 (43.3%). The overall accuracy of intra-operative FS diagnosis was 95.5%. The sensitivity for FS diagnosis was 100% for benign, 72.7% for borderline and 88.4% for malignant category, whereas the specificity was 97.3%, 97.9%, and 100.0%, respectively. There were 4 cases with discordance between the FS diagnoses and the final diagnoses, all of which were under-diagnosed by FS.ConclusionFrozen section is a good tool for decision making at the time of ovarian surgery but does not always provide an immediate solution. However a large prospective study is recommended.