[947] The Utility of Frozen Section in Assessing Surgical Margins in Robotic Prostatectomies

M Quick, M Lindberg, M Cox, R Madi, N Gokden. University of Arkansas for Medical Sciences, Little Rock, AR

Background: There is little data on the utility of intraoperative frozen section in evaluating the surgical margins in robotic prostatectomies (RP). The purpose of this study is to evaluate the utility of frozen sections in assessing benign and/or malignant prostatic glands at the periphery of the RPs.
Design: Tissues for intraoperative consultation were sent by surgeons due to visual suspicion for prostatic tissue at the prostatic bed in 129 consecutive RPs performed between September 2007 and July 2009. Retrospectively, frozen sections and corresponding permanent sections were reviewed for presence of benign or malignant prostatic glands. Fifty-five cases of 129 had frozen sections (43%), with a range of 1 to 6 frozen sections performed per case (mean 2).
Results:

Results of the margins and the diagnoses in frozen and permanent sections
FeaturesFrozenPermanent
Fibromuscular/Fibroconnective tissue4446
Prostatic stroma2928
benign prostatic glands3129
Prostate cancer56
Frozen negative/permanent positive1
Frozen positive/permanent negative0
# cases with any discrepancies12


The negative predictive value of benign prostatic glands by frozen was 99%. The positive predictive value for malignant prostatic glands by frozen was 100%. The positive predictive value of malignant prostatic tissue by intraoperative visual assessment was 9%. The negative predictive value of negative tissue margins by intraoperative visual assessment was 71.6%.
Conclusions: Frozen section has both high positive and negative predictive values in assessing benign / malignant prostatic glands. On the other hand, intraoperative visual assessment by surgeon has low predictive value for prostatic glands in robotic prostatectomies. Our data supports that frozen section is a reliable method to evaluate margins for benign and malignant glands in RP, and should be used liberally regardless of the experience of the surgeon due to its higher predictive values.
Category: Genitourinary (including renal tumors)

Monday, March 22, 2010 1:00 PM

Poster Session II # 121, Monday Afternoon

 

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