Frozen section detection of lymph node XXXX in prostatic carcinoma: accuracy in grossly uninvolved pelvic lymphadenectomy specimens.

@entity1 @entity3
We reviewed our frozen section experience with 310 pelvic lymphadenectomy specimens during the last 5 years. A total of 40 @entity1 (12.9 per cent) had positive lymph nodes on permanent section. In 6 of these @entity1 the lymph nodes were involved grossly and in 34 there were only microscopic @entity3 . Intraoperative assessment of lymph node involvement classified correctly 299 @entity1 (96.5 per cent of the total number). Whereas previous studies have demonstrated a failure on frozen section to detect all but a few microscopic @entity3 , we were able by frozen section to identify @entity3 in 23 of 34 @entity1 (67.6 per cent) with grossly uninvolved lymph nodes. Of the positive frozen sections 16 were in @entity1 with unilateral @entity3 only, and in 13 of these cases frozen section identified the only positive node present. The average diameter of the @entity3 found on frozen section was 2.4 mm. In 11 of the 34 @entity1 frozen section did not disclose any of the @entity3 present on permanent sections (average 1.4 mm.) (false negative rate 3.5 per cent of all @entity1 , 27.5 per cent of those with positive nodes and 32.3 per cent of those with microscopic involvement of lymph nodes only). Ten @entity1 had unilateral @entity3 and 1 had bilateral involvement. The ability to identify the majority of microscopic @entity3 , given their adverse effect on prognosis, supports the usefulness of routine frozen section on grossly uninvolved pelvic lymph nodes as a staging procedure before radical prostatectomy.
