Intraoperative Consultation in Gynecologic Pathology: Introduction

Abstract

The primary function of intraoperative consultation is to provide a tissue evaluation that is as accurate and prompt as possible and to effectively communicate the findings to the operating surgeon to guide subsequent surgical management of the patient. The primary goals of frozen section diagnosis include the evaluation of the presence of malignancy, tumor assessment of the primary site, histological type and grade, and assessment of the extent of local tumor invasion and distant metastasis.

However, there is no standardized practice for surgeons in requesting intraoperative consultation. Indications for frozen section evaluation vary significantly among institutions and even among gynecologic oncologists within the same institution. In principle, a request for intraoperative consultation is acceptable if a tissue sample is submitted with a question for an answer, upon which a real-time clinical decision has to be made for subsequent surgical or medical management of the patient. It is important that the frozen section will retain its relevance only in the context of broad clinical knowledge of the pathologist and judicious utilization by the surgeon, both in the ultimate service of the patient.