Indications et resultats de l'examen extemporane des ganglions pelviens dans la strategie chirurgicale des cancers du col uterin de stade Ib ou II

The aim of this study was to evaluate the accuracy of frozen section examination of lymph nodes and its place in the surgical management of early stage cervical cancer. This study was based on 80 patients with stage Ib (n = 76) or IIa (n = 4) invasive cervical carcinoma, with tumor size < 3 cm, treated by radical hysterectomy with pelvic lymphadenectomy with frozen section examination of pelvic lymph nodes. A total of 718 nodes were submitted to frozen section examination. Only one case of false-negative result was found (micrometastases). The sensitivity of frozen section examination in detecting metastatic nodes was 92.3%, its specificity was 100% and its negative predictive value was 97%. Frozen section diagnosis of pelvic nodes is a reliable procedure and should be carried out on obturator, external iliac and common iliac nodes. It should, therefore be performed in patients with early cervical carcinoma to avoid routine para-aortic lymphadenectomy.