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Follicular and Hürthle cell thyroid neoplasms. Is frozen-section evaluation worthwhile?
A Paphavasit1, G B Thompson, I D Hay
1Division of Gastroenterologic and General Surgery, Mayo Clinic, Rochester, Minn., USA.
Archives of Surgery (Chicago, Ill. : 1960)
|June 1, 1997
Summary
Frozen-section (FS) evaluation of follicular and Hürthle cell neoplasms (FHCNs) is accurate and cost-effective. This method aids intraoperative decision-making, improving surgical management and saving significant hospital costs.
Area of Science:
- Endocrinology
- Surgical Pathology
- Oncology
Background:
- Follicular and Hürthle cell neoplasms (FHCNs) of the thyroid present diagnostic challenges.
- Accurate intraoperative assessment is crucial for appropriate surgical management.
Purpose of the Study:
- To evaluate the accuracy of frozen-section (FS) analysis for FHCNs.
- To determine if FS aids in intraoperative decision-making.
- To assess the cost-effectiveness of FS in managing these thyroid neoplasms.
Main Methods:
- Retrospective review of patient data and histological slides (frozen-section and permanent).
- Analysis of diagnostic accuracy metrics: sensitivity, specificity, predictive values, and overall accuracy.
- Comparison of hospital charges for single versus two-stage surgical operations.
Main Results:
- Frozen-section evaluation demonstrated high accuracy (98%) for diagnosing malignant FHCNs.
- Sensitivity was 78%, specificity 99%, positive predictive value 90%, and negative predictive value 98%.
- Significant cost savings of approximately $400,000 were achieved by reducing the need for staged surgeries.
Conclusions:
- Frozen-section analysis of FHCNs is a highly accurate diagnostic tool.
- Intraoperative FS evaluation facilitates definitive surgical management.
- The use of FS for FHCNs leads to substantial cost reductions.