Evaluation of a frozen section protocol in endometrial carcinoma

Between May 1987 and December 1991 sixty four patients with Stage I Endometrial carcinoma were treated primarily with surgery at the University of Colorado Health Sciences Center, Denver and at hospitals in the Tampa Bay Metropolitan region. A frozen section protocol on the hysterectomy specimen was utilized in a uniform manner at all institutes. The aim of the study was to determine the speed and accuracy of this protocol in determining the dominant grade of the tumor and depth of invasion of the myometrium. The accuracy rate for reporting dominant tumor grade when compared to permanent histology was 100% for 33 specimens and 93.6% for the remaining 31 specimens. The overall accuracy for depth of myometrial invasion was expressed as a comparison of the average ratio of myometrial invasion to adjacent uninvolved myometrial thickness between frozen and permanent histology specimens. The correlation was 97.7% in this study. The average time taken was 12.6 minutes for 16 specimens, 18.8 minutes for 33, and 32.4 minutes for 17. A case is made in this paper for the value of such intraoperative information being made available to the surgeon on a routine basis.