Frozen section accuracy in the lymph node staging of prostatic carcinoma

Abstract

— We investigated the accuracy of frozen sections in the detection of pelvic lymph node metastases in prostatic carcinoma. A group of 77 patients with clinical stage B or C prostatic cancer underwent staging pelvic lymphadenectomy followed by radical prostatectomy in 71 cases. Frozen section examination was performed in 46 cases because of the presence of suspicious lymph nodes. The accuracy of frozen section was 95.5% with 5.4% false negative results. Out of 24 patients with lymph node metastases confirmed by paraffin sections, 20 had frozen sections: 9 positive for cancer, 2 false negatives and 9 true negatives. Of the 31 patients from whom frozen sections were not obtained, 4 were found to have lymph node metastases on paraffin sections. In these 4 cases and in the presence of true negative frozen sections, nodal disease was minimal in 75% of patients. The results suggest that frozen sections are a useful tool to detect lymph node metastases. The accuracy depends on the experience of the histopathologist and the volume of the metastases.