Ovarian intraoperative consultation: A 5-year study on diagnostic concordance of 657 cases

Abstract

Diagnostic accuracy is critical in the assessment of ovarian lesions at the time of intraoperative consult (IOC), as surgical decision making is greatly affected by the type of diagnosis rendered. In this study, we aimed to assess the diagnostic accuracy of ovarian IOC at a major academic center over a 5-year period. A total of 657 cases of ovarian lesions were included within the study. The overall accuracy of diagnosis by biological behavior was 94.2 %, and the sensitivity of IOC diagnosis was 98.7 %, 88.5 %, and 87.1 % for benign, borderline, and malignant categories, respectively. Major diagnostic errors were predominantly secondary to sampling errors, with mucinous tumors posing a challenge with frequent upgraded diagnosis. While the assessment of ovarian IOC has been assessed in the past, our study incorporates high case volumes with subsequent diversity of neoplastic lesions encountered at a major tertiary academic center. This study continues to emphasize the importance of ovarian IOC, the overall high accuracy rate, and the dependence on IOC to guide clinical colleagues.

Keywords: Concordance; Frozen section; Intraoperative consultation; Ovary; Quality.