Reliability of frozen section examination in identifying poor prognostic indicators in stage I endometrial adenocarcinoma.

Abstract:

:Management of Stage I adenocarcinoma of the uterus includes hysterectomy, bilateral salpingo-oophorectomy, and selective paraaortic and pelvic lymphadenectomy. Postoperative radiation therapy (RT) is selectively employed in patients with histologically defined poor prognostic indicators. We attempted to identify these poor prognostic indicators by frozen section (FS) at primary surgery in 55 patients with Stage I endometrial adenocarcinoma; we found an excellent correlation between the results obtained on gross examination of the uterus with selected FS and the results after extensive sampling and microscopic examination of permanent section (PS). The depth of myometrial invasion was accurately predicted in 96.5%, and histologic grade in 94.5% of these patients. Sixty-six percent of patients with occult invasion of the cervix on PS were identified on FS. Using the above criteria, we identified by FS all patients (15/55) who required adjuvant RT obviating the need for pelvic lymph node dissection. On the basis of our preliminary data, we recommend the use of careful gross examination and selective FS to identify patients requiring selective pelvic and paraaortic lymphadenectomy and adjuvant therapy, thereby eliminating the need for staging lymph node dissection with its associated morbidity and complications.

journal_name

Gynecol Oncol

journal_title

Gynecologic oncology

authors

Malviya VK,Deppe G,Malone JM Jr,Sundareson AS,Lawrence WD

doi

10.1016/0090-8258(89)90162-5

subject

Has Abstract

pub_date

1989-09-01 00:00:00

pages

299-304

issue

3

eissn

0090-8258

issn

1095-6859

journal_volume

34

pub_type

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