[Frozen section in urological oncology].

Area of Science:

• Urologic Oncology
• Surgical Pathology

Context:

• Frozen section diagnosis (FS) constitutes only 7.3% of general hospital FS procedures.
• Indications for FS in urologic neoplasia are specific and require careful consideration.

Purpose:

• This review clarifies the specific indications and utility of FS in urologic oncology.
• To guide clinicians on the appropriate use of intraoperative consultations in managing urologic cancers.

Summary:

• FS is generally not recommended for tumor diagnosis, with exceptions for ambiguous renal/urinary tract masses, testicular neoplasms favoring conservative treatment, and prostate adenocarcinoma in organ donors (controversial).
• Intraoperative margin assessment using FS is vital in partial nephrectomies, urethral margins during cystectomies, and partial penectomies.
• Node evaluation with FS is debated, but recommended for intermediate/high-risk penile carcinoma, especially sentinel node biopsy, despite a 16-18% false-negative rate.

Impact:

• Optimizing the use of FS can improve surgical decision-making and patient outcomes in urologic oncology.
• Clarifying FS indications may reduce unnecessary procedures and resource utilization.