TITLE:
Is the Use of Frozen Section Indispensable in the Surgical Treatment of Endometrial Hyperplasia?
AUTHORS:
Ceyhun Numanoglu, Dilek Marangoz Chapman, Aysun Fendal Tunca, Aysu Akca, Agahan Han, Volkan Ulker, Ozgur Akbayir
KEYWORDS:
Endometrial Hyperplasia, Coexisting Endometrial Cancer, Atypical Endometrial Hyperplasia, Frozen Section, Hysterectomy
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.5 No.4,
April
14,
2015
ABSTRACT:
Objective: To evaluate the reliability and accuracy of frozen
section (FS) compared with final pathology and to determine whether they should
be obligatory in every patient with atypical endometrial hyperplasia (AEH).
Methods: We retrospectively assessed the medical records of 192 patients whose
endometrial biopsy results were endometrial hyperplasia and underwent
hysterectomy at our center. Results: Twenty-two (11.4%) of the 192 patients in
our study had concurrent endometrial carcinoma (EC). Of these, 21 (95.5%) were
EC and 1 (4.5%) was non-endome- trioid. Of the 140 patients with AEH, 20
(14.3%) had concurrent EC. Overall, 157 patients had FS. Two (1%) patients’ EC
was higher than grade 1B and needed lymphadenectomy. The positive and negative
predictive value, specifity and sensitivity of FS were found to be 77.8%,
95.7%, 97% and 70%, respectively. Conclusion: Patients who have AEH without
high-risk comorbidities do not have to be referred to oncology centers and can
undergo hysterectomy in community hospitals without FS.