ADVANCES IN OBSTETRICS AND GYNECOLOGY

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Recently more accurate preoperative diagnoses have been achieved using several developed diagnostic tools including MRI, ultrasonography and tumor markers. However, there still remain some cases in which discrepancies between preoperative diagnoses and final diagnoses exist, because the latter depends on the histopathological investigations on specimens obtained at surgeries. To lessen the discrepancies, histopathological evaluations on frozen section samples have been used during operations. Although there have been many reports on the accuracy of intraoperative diagnosis using frozen sections, very few studies have been done to clarify how the diagnoses influence on decision-making of surgical method. We retrospectively studied the accuracy of preoperative diagnoses and their effctiveness on the selection of operative procedure. Subjects were the cases which received primary surgeries for ovarian tumors at Kyoto Prefectural University of Medicine in a period between January 1", 1995and December 31", 1998. Medical records of 177 cases were analyzed, In 124 cases frozen-section evaluation was not done because of uncomplecated preoperative diagnoses or emergency operation. In this group the accuracy of preoperative diagnoses was 98.4%. The number of cases in which frozen-section evaluation was used was53 (29.9%). Intraoperative histological evaluation for all the 53 cases were compatible with final diagnoses, while accuracy of preoperative diagnoses in those cases was 90.6%. Two (3.8%) of the 53 cases were revealed to be malignant against the preoperative diagnoses, resulting in the change of the surgical procedure. Another 3 cases (5.7%) were regarded as benign in spite of preoperative diagnoses of malignancy. However, in all the 3 cases extended surgeries were selected, because intraoperative macroscopic findings could not completely exclude the possibility of misjudgment in the intraoperative evaluation. The results of this study show that frozen-section evaluation during operation can be helpful to guide the surgeons to perform the appropriate surgical procedure in most of the cases of ovarian tumor. [Adv Obstet Gynecol 52 (4): 635-639, 2000 (H.12.7)]

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