Is the Use of Frozen Section Indispensable in the Surgical Treatment of Endometrial Hyperplasia?

Ceyhun Numanoglu^1*, Dilek Marangoz Chapman², Aysun Fendal Tunca³, Aysu Akca³, Agahan Han³, Volkan Ulker¹, Ozgur Akbayir¹

¹Oncology Unit, Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
²Ethica Incirli Hospital, Istanbul, Turkey.
³Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.

DOI: 10.4236/ojog.2015.54032                

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.

Keywords

Endometrial Hyperplasia, Coexisting Endometrial Cancer, Atypical Endometrial Hyperplasia, Frozen Section, Hysterectomy

Conflicts of Interest

The authors declare no conflicts of interest.

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