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Bader, AA; Winter, R; Moinfar, F; Petru, E; Pristauz, G; Scholz, HS; Haas, J; Tamussino, KF.
Is intraoperative frozen section analysis of pelvic lymph nodes accurate after neoadjuvant chemotherapy in patients with cervical cancer?
Gynecol Oncol. 2006; 103(1):106-112
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Autor/innen der Med Uni Graz:
Bader Arnim
Haas Josef
Moinfar Farid
Petru Edgar
Pristauz-Telsnigg Gunda
Scholz Heinz
Tamussino Karl
Winter Raimund
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Abstract:
OBJECTIVE: Intraoperative frozen section examination of pelvic lymph nodes is frequently used in patients with cervical cancer, some of whom have received neoadjuvant chemotherapy (NACT). However, NACT can cause necrosis, fibrosis, or keratinization of tumor deposits in extirpated lymph nodes, and it is unclear whether intraoperative frozen section analysis of extirpated nodes is accurate after NACT. We analyzed the accuracy of frozen section examination of pelvic lymph nodes in patients after NACT for cervical cancer. METHODS: We reviewed 134 patients with invasive cervical cancer who underwent surgery including systematic pelvic lymphadenectomy with intraoperative frozen section examination of pelvic lymph nodes. Results of frozen section examination were related to definitive histology and compared between patient groups of NACT and primary surgery. RESULTS: A total of 1670 pelvic lymph nodes were evaluated intraoperatively by frozen section examination, and 6689 pelvic lymph nodes were analyzed by final histopathology. Overall frozen section analysis had nine false negative results among 53 patients with positive lymph nodes (false negative rate, 16.9%). After NACT, there were two false negative diagnoses in twelve patients with node metastases (false negative rate, 16.7%). No false positive cases were noted. The sensitivity and negative predictive value of frozen section examination were 83% and 82%, respectively, in patients after NACT, and 83% and 91% at primary surgery. CONCLUSION: NACT does not appear to compromise the diagnostic accuracy of intraoperative frozen section examination of pelvic lymph nodes in patients with cervical cancer.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Aged -
Female -
Frozen Sections -
Humans -
Intraoperative Care -
Lymph Node Excision -
Lymph Nodes - pathology
Lymphatic Metastasis - pathology
Middle Aged - pathology
Neoadjuvant Therapy - pathology
Neoplasm Staging - pathology
Pelvis - pathology
Sensitivity and Specificity - pathology
Uterine Cervical Neoplasms - drug therapy

Find related publications in this database (Keywords)
cervical cancer
lymph nodes
frozen section
neoadjuvant chemotherapy
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