INTRAVAGINAL AMPUTATION OF THE UTERINE CERVIX WITH FROZEN-SECTION EXAMINATION OF THE ENDOCERVICAL MARGIN - A REVIEW OF 414 CONSECUTIVE PATIENTS

We report our institutional experience with the accuracy and usefulnes s of cervical amputations with frozen section evaluation of the endoce rvical margin in the management of preinvasive squamous epithelial les ions. Four hundred and fourteen consecutive patients, who underwent am putation of the cervix because of a preinvasive epithelial lesion, or discrepancy between cytologic and biopsy findings especially when colp oscopic evaluation was unsatisfactory, had frozen section evaluation o f the endocervical margin. Medical records were reviewed and pathologi c findings were compared with those obtained on paraffin embedded sect ions. Frozen section analysis of the upper endocervical margin led to the diagnosis of a residual lesion in 90 (21.7%) cases. In 59 (14.2%) of these eases a further excision was performed during the same operat ive procedure leading to complete resection in 34 (8.2%) cases. In 403 (97.3%) cases the diagnosis based on the frozen section was corrobora ted by the permanent sections. For the diagnosis of insufficient cervi cal resection, the sensitivity and specificity of frozen sections were 93.8% and 99.7% respectively. We conclude that frozen section evaluat ion of the upper endocervical margin at the lime of cervical amputatio n is a reliable procedure that increases the rate of complete resectio n. The risks associated with additional anesthesia are then reduced, a s are inconvenience to the patients and costs.