2Department of Radiation Oncology, Kocaeli University, Kocaeli-Türkiye
3Department of Radiation Oncology, Sakarya University, Sakarya-Türkiye DOI : 10.5505/tjo.2022.3522 OBJECTIVE
The aim of this study was to evaluate the compatibility of tumor grades in pre-operative biopsies, frozen sections and post-operative specimens and to evaluate the adequacy of a selective surgical staging policy based on information obtained from intra-operative frozen sections to avoid lymphadenectomy in patients with endometrial cancer (EC).
METHODS
Ninety patients diagnosed with EC were analyzed. Fifty-four patients were at Stage I (60%), 19 were at
Stage II (21%) and 17 (19%) were at Stage III. Fifty-four patients (60%) had grades on pre-operative
biopsies, 31 patients (34%) had grades on frozen sections and 88 patients (98%) had grades on postoperative
specimens. Depth of myometrial invasion was reported in 54 patients (60%) based on frozen
sections and in all patients on post-operative specimens. Eight patients (9%) underwent no lymphadenectomy,
32 patients (36%) underwent pelvic lymphadenectomy and 50 patients (55%) underwent
pelvic and para-aortic lymphadenectomy.
RESULTS
There were five patients for whom tumors were up-graded when pre-operative biopsies and frozen sections
were. There were 17 patients for whom tumors were up-graded and four patients for whom tumors
were down-graded when pre-operative biopsies and post-operative specimens were compared. There
were six patients for whom tumors were up-graded when frozen sections and post-operative specimens
were compared and the distribution of patients between intra-operatively and post-operatively assigned
tumor grade groups was statistically significant.
CONCLUSION
For surgeons who do not perform complete surgical staging for every patient with EC, clinical judgment
should only be efficient when augmented with information obtained from frozen sections.