Diagnostic Role & Accuracy of Intra-Operative Frozen Section in The Surgeries for Gastric and Gastro-Esophageal Malignancies

Abstract

Introduction: Frozen section (FS) is an important and rapid intra-operative tool to assess primary pathology/ malignancy, diagnose metastatic malignancy and to ensure negative resection margins during the respective surgeries for gastric and gastrooesophageal malignancies, which can subsequently impact patient prognosis and management. Objective: To assesses the accuracy, sensitivity and specificity of intraoperative FS consultation in surgeries for gastric and gastro-oesophageal malignancies, in correlation with the final histopathology. Methods: Over a period of 2 and 1⁄2 years, the results of gastric cancer patients who had undergone intraoperative FS consultation, were prospectively analyzed in comparison with the corresponding histopathology. The overall accuracy, sensitivity and specificity were calculated for all the specimen, as well as for margins. The discordant cases were reviewed to analyze the cause of the error. Results: In total, 67 specimens were obtained from the 45 patients undergoing total and partial gastric resection surgery. The accuracy, sensitivity, and specificity of frozen-section assessments were 94.02%, 96% and 92.8% respectively for all the specimen. There were 4 discordant cases. The accuracy, sensitivity and specificity for margin assessment were 100%, 100% and 100% respectively. Conclusion: Intraoperative FS examination is a highly accurate method which can be utilized for achieving rapid intra-operative diagnosis and negative margins, which is very essential for complete tumour extirpation in gastric and gastro-oesophagal malignancies.