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EPV082/#511 Routine pelvic lymph node frozen section examination in preventing ineffective dual modality management in early-stage cervical cancer
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  1. C Pappa1,
  2. S Smyth2,
  3. H Jiang1,
  4. C Johnson3,
  5. M Mccole4,
  6. S Damato4,
  7. S Wood1,
  8. H Soleymani Majd1 and
  9. M Alazzam1
  1. 1Oxford University Hospital NHS Foundation Trust, Gynaecology Oncology Department, Oxford, UK
  2. 2Oxford University Hospitals NHS Foundation Trust, Gynaecological Oncology, Oxford, UK
  3. 3Oxford University Hospitals NHS Foundation Trust, Radiology, Oxford, UK
  4. 4Oxford University Hospitals NHS Foundation Trust, Oxford, UK, Cellular Pathology, Oxford, UK

Abstract

Objectives Cervical cancer is one of the most common malignancies mainly affecting young women. Surgical management including pelvic lymphadenectomy comprise the cornerstone in the treatment of early-stage cervical carcinomas. Our aim is to evaluate the role of intraoperative pelvic lymph nodes FSE in the surgical management of early-stage cervical cancer to prevent ineffectual radical surgery and its potential complications.

Methods A retrospective study of 30 consquetive women aged between 23 and 82 years (mean age 37±7 years) was conducted in our department. All women had a diagnosis of stage Ib1 or less cervical malignancy with a tumor size less than 20mm. Trachelectomy was performed when lymph nodes FSE in both pelvic sides were negative. In case of positive nodes in FSE any further surgical procedure was abandoned.

Results The mean number of pelvic PSE LNs excised bilaterally was 19±6. Four out of 30 women (13.3%) were found to have positive LNs at frozen section examination. No false positive cases were proved after the final paraffin histopathology examination. The mean time from LNs excision to FSE report was 82.3±20.4 minutes.

Conclusions According to our study, FSE constitutes a reliable method in detecting unsuspected invasive cervical cancer. Despite the increased surgical duration and the potential to augment intraoperative complications, FSE can be used in the interest of optimal management by preventing bimodal treatment and long-term morbidity.

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