Diagnostic Performance of Frozen Section in Detecting Myometrial invasion and Cervical extension in Endometrial Carcinoma
Frozen Section in Endometrial Carcinoma Diagnosis
DOI:
https://doi.org/10.3329/bmrcb.v51i03.84709Keywords:
Endometrial cancer, frozen section, cervical extension, myometrial invasionAbstract
Background: Low-risk endometrial cancer is treated with total hysterectomy and bilateral salphingo oophorectomy. High-risk patients need detailed surgical staging including lymphadenectomy. An accurate preoperative work up and assessment of high-risk features during surgery is essential. So, an intraoperative frozen section is important for guiding surgical decisions by checking for myometrial invasion and cervical extension.
Objective: To assess the diagnostic performance of frozen section in detecting myometrial invasion and cervical extension in endometrial carcinoma.
Methods: This cross-sectional study was conducted at the Department of gynecological oncology at Bangladesh Medical University, Dhaka, from December 2022 to December 2023. We included 31 patients with histo pathologically confirmed endometrial cancer (by fractional or diagnostic curettage) who underwent surgery. During surgery, frozen section of resected uterus was done and sent to pathology department to comment for deep myometrial invasion (≥50%) and the presence of cervical involvement within one hour. Later on, histopathology was done on the resected uterus. Finally, frozen section report was compared with final histopathology findings.
Results: The mean age of participants was 56.3 years, ranging from 35 to 70. Most were postmenopausal (83.9%) and nearly two-thirds had low parity. Common health issues included obesity (38.7%), diabetes, and hypertension (45.2%). To detect deep myometrial invasion compared to histopathology; the frozen section showed sensitivity 90.0%, specificity 95.2%, and overall accuracy 93.5%. To detected cervical extension compared to histopathology; the frozen section showed sensitivity 77.8%, specificity 95.5%, and accuracy 90.3%, with few false positive and negative results.
Conclusions: Frozen section is a reliable intraoperative method for evaluating myometrial invasion and cervical extension in endometrial cancer. It offers surgeons valuable real-time information, helping to guide surgical staging and treatment plans, for better patient outcomes.
Bangladesh Medical Res Counc Bull 2025;51(3): 139-144
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Copyright (c) 2025 Mahmuda Sultana, Md. Sazzad Hossain, Shah Md. Ezaz-ul Haque, Sadika Tasnim, Latifa Akhter, Jannatul Ferdous
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