Use of frozen section in genitourinary pathology.

Frozen section diagnosis provides critical information for immediate surgical management decision making. Over the last several years, there have been some significant advances in treatment of genitourinary cancer, particularly with regard to surgical techniques. These changes in turn impact the type and frequency of intraoperative frozen section requests. In this review, we describe the main indications and diagnostic challenges of frozen section diagnosis during surgeries of each genitourinary organ system including prostate, kidney, bladder, testis, and penis. The pitfalls and approaches to different diagnostic situations are discussed. It is also stressed that pathologists must not only be familiar with the histological diagnosis, but also understand the limitations of frozen section diagnosis and communicate with urologists during the intraoperative treatment decision making process.

[1]  R. Uzzo,et al.  Current Status of Robot-Assisted Partial Nephrectomy , 2012, Current Urology Reports.

[2]  D. Jacqmin,et al.  Radical Nephrectomy with and without Lymph Node Dissection: Preliminary Results of the EORTC Randomized Phase III Protocol 30881 , 1999, European Urology.

[3]  A. Vickers,et al.  Significance of intraoperative ureteral evaluation at radical cystectomy for urothelial cancer , 2006, Cancer.

[4]  Li-Ming Su,et al.  Robot-assisted radical prostatectomy: advances since 2005 , 2010, Current opinion in urology.

[5]  G. Jager Sensitivity of frozen section examination of pelvic lymph nodes for metastatic prostate carcinoma , 1996, Cancer.

[6]  B. Konety,et al.  Quality of Evidence to Compare Outcomes of Open and Robot-Assisted Laparoscopic Prostatectomy , 2011, Current urology reports.

[7]  A. Novick,et al.  Nephron sparing surgery for renal tumors: indications, techniques and outcomes. , 2001, The Journal of urology.

[8]  J. Epstein,et al.  Ureteral frozen section analysis during cystectomy: a reassessment. , 1996, The Journal of urology.

[9]  J. Epstein,et al.  Characteristics of positive surgical margins in robotic-assisted radical prostatectomy, open retropubic radical prostatectomy, and laparoscopic radical prostatectomy: a comparative histopathologic study from a single academic center. , 2012, Human pathology.

[10]  Liang Cheng,et al.  International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 5: surgical margins , 2011, Modern Pathology.

[11]  A. Hemal,et al.  Robot-assisted urologic surgery in 2010 – Advancements and future outlook , 2011, Urology annals.

[12]  M. Cooperberg,et al.  Treatment trends for stage I renal cell carcinoma. , 2011, The Journal of urology.

[13]  K. Bensalah,et al.  Positive surgical margin appears to have negligible impact on survival of renal cell carcinomas treated by nephron-sparing surgery. , 2010, European urology.

[14]  I. Derweesh,et al.  Continuing trends in pathological stage migration in radical prostatectomy specimens. , 2004, Urologic oncology.

[15]  D. Son,et al.  Histology and distribution of prostatic tissue on prostatic urethral margins: evaluation of radical prostatectomy specimens and implications on frozen section analysis. , 2012, Annals of diagnostic pathology.

[16]  U. Studer,et al.  Is there an indication for frozen section examination of the ureteral margins during cystectomy for transitional cell carcinoma of the bladder? , 2006, The Journal of urology.

[17]  E. Wallen,et al.  Prospective randomized controlled trial of robotic versus open radical cystectomy for bladder cancer: perioperative and pathologic results. , 2010, European urology.

[18]  C. Magi-Galluzzi,et al.  Prostate Cancer Staging and Grading at Radical Prostatectomy Over Time , 2011, Advances in anatomic pathology.