Article Data

  • Views 822
  • Dowloads 136

Original Research

Open Access

The role of intraoperative consultation in the management of ovarian masses and endometrial carcinomas: a 7-year experience

  • Nurhan Sahin1,*,
  • Busra Cosanay Tekden1
  • Ganime Coban1
  • Gurkan Kiran2
  • Dilek Sema Arici3
  • Ozlem Toluk4
  • Zuhal Gucin1

1Department of Pathology, Bezmialem Vakif University, 34093 Istanbul, Turkey

2Department of Obstetric and Gynecology, Bezmialem Vakif University, 34093 Istanbul, Turkey

3Department of Pathology, Biruni University, 34010 Istanbul, Turkey

4Department of Biostatistics and Medical Informatics, Bezmialem Vakif University, Faculty of Medicine, 34093 Istanbul, Turkey

DOI: 10.22514/ejgo.2024.011 Vol.45,Issue 1,February 2024 pp.70-75

Submitted: 16 May 2023 Accepted: 28 June 2023

Published: 15 February 2024

*Corresponding Author(s): Nurhan Sahin E-mail:


Intraoperative consultation (IC) is often used for surgical planning in gynecological oncology, primarily in ovarian and endometrial cancer surgery. However, there is limited research that compares IC diagnoses and results from definitive analyses. This retrospective study compares IC results and definitive analysis findings in terms of ovarian mass diagnoses and endometrial carcinoma patients consulted for myometrial invasion (MI) depth across 7 years (2012–2019). IC was performed in 282 cases to evaluate ovarian masses. The sensitivity of IC was 94% for benign ovarian masses and 90% for malignant ovarian masses. 92 cases were submitted to IC for endometrial carcinoma. Sensitivity was 80% for tumors with <50% MI and 74% for tumors with ≥50% MI. IC is an important method with high sensitivity and specificity for diagnosing ovarian masses and determining MI depth in endometrial carcinomas.


Frozen section; Intraoperative consultation; Endometrial carcinoma; Ovarian masses

Cite and Share

Nurhan Sahin,Busra Cosanay Tekden,Ganime Coban,Gurkan Kiran,Dilek Sema Arici,Ozlem Toluk,Zuhal Gucin. The role of intraoperative consultation in the management of ovarian masses and endometrial carcinomas: a 7-year experience. European Journal of Gynaecological Oncology. 2024. 45(1);70-75.


[1] Baker P, Oliva E. A practical approach to intraoperative consultation in gynaecological pathology. International Journal of Gynecological Pathology. 2008; 27: 353–365.

[2] Aidos J, Verissimo R, Almeida J, Carvalho T, Martins NN, Martins FN. Frozen section in the management of ovarian and uterine tumours: the past 5 years in a tertiary centre. Rev Bras Ginecol Obstet. 2018; 40: 458–464.

[3] Park JY, Lee SH, Kim KR, Kim YT, Nam JH. Accuracy of frozen section diagnosis and factors associated with final pathological diagnosis upgrade of mucinous ovarian tumours. Journal of Gynecologic Oncology. 2019; 30: e95.

[4] Abu-Rustum NR, Yashar CM, Arend R, Barber E, Bradley K, Brooks R, et al. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Uterine Neoplasms. 2023. Available at: (Accessed: 28 April 2023).

[5] Marinone M, Shrestha E, Thapa A, Tuladar R, Wakefield DB, Chuang L. Surgical management of ovarian tumors without the support of T intraoperative pathology readings in Bhaktapur cancer hospital. Gynecologic Oncology Reports. 2020; 33: 100589.

[6] Tepe NB, Bozdag Z, Balat O, Ugur MG, Ozcan HC, Sucu S, et al. Is intraoperative frozen examination sufficiently reliable for ovarian tumours: 11 years experience at a single center. European Journal of Gynaecological Oncology. 2019; 40: 628–633.

[7] Gol M, Baloglu A, Yigit S, Dogan M, Aydin C, Yensel U. Accuracy of frozen section diagnosis in ovarian tumours: is there a change in the course of time? International Journal of Gynecological Cancer. 2003; 13: 593–597.

[8] Palakkan S, Augestine T, Valsan MK, Vahab KP, Nair LK. Role of frozen section in surgical management of ovarian neoplasm. Gynecology and Minimally Invasive Therapy. 2020; 9: 13–17.

[9] Yarandı F, Eftekhar Z, Izadi-Mood N, Shojaei H. Accuracy of intraoperative frozen section in the diagnosis of ovarian tumours. Australian and New Zealand Journal of Obstetrics and Gynaecology. 2008; 48: 438–441.

[10] Sukumaran R, Somanathan T, Mathews A, Kattor J, Sambasiwan S, Nair RP. Role of frozen section in intraoperative assessment of ovarian masses: a tertiary oncology centre experience. Indian Journal of Surgical Oncology. 2014; 5: 99–103.

[11] Kung FY-L, Tsang AK, Yu EL. Intraoperative frozen section analysis of ovarian tumours: an 11-year review of accuracy with clinicopathological correlation in a Hong Kong Regional hospital. International Journal of Gynecological Cancer. 2019; 29: 772–778.

[12] Gultekin E, Gultekin OE, Cingillioglu B, Sayhan S, Sanci M, Yildirim Y. The value of frozen section evaluation in the management of borderline ovarian tumours. Journal of Cancer Research and Therapeutics. 2011; 7: 416–420.

[13] Subbian A, Devi UK, Bafna UD. Accuracy rate of frozen section studies in ovarian cancers: a regional cancer institute experience. Indian Journal of Cancer. 2013; 50: 302–305.

[14] Kumar AS, Chander V, Parthasarathy J. Diagnostic accuracy of intraoperative frozen section analysis in correlation with histopathological diagnosis of ovarian tumors in a tertiary care center—a retrospective study. Cancer Investigation. 2021; 39: 153–158.

[15] Houck K, Nikrui N, Duska L, Chang Y, Fuller A, Bell D. Borderline tumors of the ovary: correlation of frozen and permanent histopathologic diagnosis. Obstetrics & Gynecology. 2000; 95: 839–843.

[16] Song T, Choi CH, Kim HJ, Kim MK, Kim TJ, Lee JW, et al. Accuracy of frozen section diagnosis of borderline ovarian tumors. Obstetrics & Gynecology. 2011; 122: 127–131.

[17] Brun J, Cortez A, Rouzier R, Callard P, Bazot M, Uzan S, et al. Factors influencing the use and accuracy of frozen section diagnosis of epithelial ovarian tumors. American Journal of Obstetrics and Gynecology. 2008; 199: 244.e1–244.e7.

[18] Basaran D, Salman MC, Boyraz G, Selcuk I, Usubutun A, Ozgul N, et al. Accuracy of intraoperative frozen section in the evaluation of patients with adnexal mass: retrospective analysis of 748 cases with multivariate regression analysis. Pathology and Oncology Research. 2015; 21: 113–118.

[19] Tempfer C, Polterauer S, Bentz E, Reinthaller A, Hefler L. Accuracy of intraoperative frozen section analysis in borderline tumors of the ovary: a retrospective analysis of 96 cases and review of the literature. Gynecologic Oncology. 2007; 107: 248–252.

[20] Açikalin A, Torun G, Bagir E, Bayram F, Zeren H, Gulec U, et al. Intraoperative frozen section in ovarian neoplasms; a tertiary centre experience. Turkish Journal of Pathology. 2014; 30: 184–188.

[21] Morton R, Anderson L, Carter J, Pather S, Saidi SA. Intraoperative frozen section of ovarian tumors: a 6-year review of performance and potential pitfalls in an Australian tertiary referral centre. International Journal of Gynecological Cancer. 2017; 27: 17–21.

[22] Acikalin A, Gumurdulu D, Bagir EK, Torun G, Guzel AB, Zeren H, et al. The guidance of intraoperative frozen section for staging surgery in endometrial carcinoma. Pathology & Oncology Research. 2015; 21: 119–122.

[23] Wang X, Li L, Cragun JM, Chambers SK, Hatch KD, Zheng W. Assessment of the role of intraoperative frozen section in guiding surgical staging for endometrial cancer. International Journal of Gynecologic Cancer. 2016; 26: 918–923.

[24] Khalifa MA, Salama S, Vogel RI, Klein ME, Richter J, Pulver T, et al. Assesment of the intraoperative consultation service rendered by general pathologists in a scenario where a well-defined decision algorithm is followed. American Journal of Clinical Pathology. 2017; 147: 322–326.

[25] Bandala-Jacques A, Cantú-de-León D, Pérez-Montiel D, Salcedo-Hernández RA, Prada D, González-Enciso A, et al. Diagnostic performance of intraoperative assessment in grade 2 endometrioid endometrial carcinoma. World Journal of Surgical Oncology. 2020; 30: 284.

[26] Karabagli P, Ugras S, Yilmaz BS, Celik C. The evaluation of reliability and contribution of frozen section pathology to staging endometrioid adenocarcinomas. Archives of Gynecology and Obstetrics. 2015; 292: 391–397.

[27] Kumar S, Medeiros F, Dowdy SC, Keeney GL, Bakkum-Gamez JN, Podratz KC, et al. A prospective assessment of the reliability of frozen section to direct intraoperative decision making in endometrial cancer. Gynecologic Oncology. 2012; 127: 525–531.

[28] Gitas G, Proppe L, Alkatout I, Rody A, Kotanidis C, Tsolakidis D, et al. Accuracy of frozen section at early clinical stage of endometrioid endometrial cancer: a retrospective analysis in Germany. Archives of Gynecology and Obstetrics. 2019; 300: 169–174.

[29] Mandato VD, Torricelli F, Mastrofilippo V, Palicelli A, Ciarlini G, Pirillo D, et al. Accuracy of preoperative endometrial biopsy and intraoperative frozen section in predicting the final pathological diagnosis of endometrial cancer. Surgical Oncology. 2020; 35: 229–235.

[30] Giglio A, Miller B, Curcio E, Kuo Y, Erler B, Bosscher J, et al. Challenges to intraoperative evaluation of endometrial cancer. Journal of the Society of Laparoscopic & Robotic Surgeons. 2020; 24: e2020.00011.

[31] Laakman JM, Chen SJ, Lake KS, Blau JL, Rajan DA, Samuelson MI, et al. Using separate frozen section slide preparation times and interpretative time measurements to improve process. American Journal of Clinical Pathology. 2021; 156: 461–470.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Submission Turnaround Time