Intraoperative Gross Examination and Intraoperative Frozen Section in Patients With Endometrial Cancer for Detecting Deep Myometrial Invasion: A Systematic Review and Meta-analysis
Alcazar JL (1), Dominguez-Piriz J, Juez L, Caparros M, Jurado M.
(1) Department of Obstetrics and Gynecology, Clínica Universidad de Navarra, School of Medicine, University of Navarra, Pamplona, Spain; and †Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario, Badajoz, Spain.
Magazine: International Journal Gynecology Cancer
Date: Feb 1, 2016Control del embarazo y parto. Dar a luz. Clínica Universidad de Navarra [SP]
The aim of this study was to perform a meta-analysis comparing diagnostic performance of intraoperative gross evaluation (IGE) and intraoperative frozen section (IFS) for the assessment of myometrial invasion in patients with endometrial cancer.
An extensive search was performed in several databases from January 1989 to May 2015. Eligibility criteria were studies using intraoperative gross evaluation or intraoperative frozen section to determine deep myometrial invasion in patients with endometrial cancer using the final histopathology report with reference standard. Quality was assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Quality Assessment of Diagnostic Accuracy Studies 2 tool.
Forty-seven articles were identified. Of these, 35 studies were selected and included in the meta-analysis. A total of 6387 women were evaluated intraoperatively with any of the 2 methods mentioned. Pooled sensitivity and specificity for IGE were 71% (95% confidence interval [CI], 63%-77%) and 91% (95% CI, 89%-93%), respectively. Heterogeneity was found high for sensitivity (I2: 83.6%; Cochran Q: 79.4; P < 0.001) and moderate for specificity (I, 51.4%; Cochran Q, 29.8; P =0.01).
Pooled sensitivity and specificity for IFS were 85% (95% CI, 81%-88%) and 97% (95% CI, 96%-98%), respectively. Heterogeneity was found moderate for sensitivity (I, 56.4%; Cochran Q, 45.9; P < 0.001) and high for specificity (I, 83.2%; Cochran Q, 118.9; P < 0.001). Both sensitivity (P = 0.0008) and specificity (P = 0.0021) were significantly higher for IFS compared to IGE.
Intraoperative frozen section has better diagnostic performance than intraoperative gross evaluation for the intraoperative diagnosis of deep myometrial invasion in patients with endometrial cancer.
CITATION Int J Gynecol Cancer. 2016 Feb;26(2):407-15. doi: 10.1097/IGC.0000000000000618.
you maybe interested
The Clínica is the greater private hospital with technological equipment of Spain, all in a single center.
The professionals of the Clínica perform continuous research and training, always to the benefit of the patient.
Learn why we are different from other healthcare centers. Quality, speed, comfort and results.