The role of intraoperative frozen section analysis in the choice of surgical strategy for ovarian tumors

Malignant ovarian tumors are latent, lack specific clinical and diagnostic markers, and rarely detected at early stages resulting in suboptimal treatment outcomes. Gynecologists and oncologists often have different views of the clinical situation when the organ-sparing approach of gynecologists may run counter to the radical strategy of oncologists. Intraoperative frozen section analysis of ovarian tumors is necessary to determine tumor grade and guide surgical decision-making. Aim. To determine the sensitivity, specificity, and prognostic significance of intraoperative frozen section analysis (IFSA) in the differential diagnosis of ovarian tumors, its role in the choice of surgical strategy, and the feasibility of determining the histopathologic subtype of cancer. Materials and methods. This was a descriptive longitudinal study conducted at the Department of Innovative Oncology and Gynecology, V.I. Kulakov NMRC for OG&P. During the 2-year data collection period, 77 intraoperative frozen section analyses were performed. Results. Among 77 patients with ovarian tumors, frozen section results were reported as benign, malignant, and borderline in 20 (26%), 39 (50.6%), and 18 (23.4%) tumors. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of IFSA for detecting benign tumors were 100%, 93.4%, 77.8%, and 100%, respectively. For the detection of malignant tumors, the sensitivity specificity, PPV, and NPV were 95%, 97.1%, 97.4%, and 94.4%. However, IFSA had a lower sensitivity (76.2%) and PPV (88.9%) for the diagnosis of borderline tumors. In these ovarian neoplasms, specificity and NPV were 96.3% and 91.2%. Conclusion. IFSA is useful in the differential diagnosis of ovarian tumors and helps guide surgical decisionmaking.

ovarian cancer, ovarian epithelial tumors, oncology, diagnostics, screening, IFSA, MRI