CERVICAL CONIZATION WITH FROZEN-SECTION BEFORE PLANNED HYSTERECTOMY

Objective: To report our institutional experience with the accuracy an d usefulness of cervical conization with frozen section before planned hysterectomy. Methods: One hundred fifty-nine patients who planned to have hysterectomies for or with a concomitant diagnosis of cervical i ntraepithelial neoplasia (CIN) underwent preliminary cone biopsies wit h frozen section. The frozen and permanent pathologic diagnoses were c ompared retrospectively. Detailed analysis was directed at the indicat ions for cone biopsy and the patients who were found to have invasive cancer. Results: Among 108 patients with negative specimens or CIN, th e frozen section was accurate within one degree of CIN in 106. Cone bi opsy for a positive endocervical curettage, unsatisfactory colposcopy, or discrepant cytology did not contribute to the diagnosis of invasiv e cancer but did lead to an ultimate diagnosis of CIN III. One of 12 w omen with a frozen-section diagnosis of microinvasion had deeper invas ion on permanent sections. Conclusions: Frozen-section evaluation of a cone biopsy carries, a degree of accuracy that enables the surgeon to make an immediate decision about definitive therapy. Exact indication s, use during pregnancy, and accuracy for the diagnosis of microinvasi on require further study.