Frozen Section Analysis of Vulvectomy Specimens: Results of a 5-Year Study Period

The most important goals of surgical treatment in vulvar cancer (VCX) are complete tumor resection and adequate treatment of inguinal nodes. The status of resection margins and inguinal node involvement might be the subject of intraoperative frozen section examination. During a study period of 5 yr we determined the frequency of all gynecologic specimens among all the specimens sent for frozen section evaluation with a special focus on VCX. In the cases of VCX we determined the time necessary for frozen section, its accuracy and described our practical approach to their handling. In the 7,921 frozen section analyses, 17.5% resulted from gynecologic surgery (29.2% of the latter ones resulted from ovarian samples, 26.8% from the cervix, 15.0% from the endometrium, 17.5% from the breast, including sentinel lymph nodes, 10.6% from the vulva, and 0.8% from the vagina). The accuracy rate of vulval frozen section analyses was 100% for the evaluation of Cloquet node, and 98.6% for the margin status. The mean time necessary for frozen section analysis of the vulvectomy specimens was 24.5 min (range 6 to 44 min). Gynecologic specimens are frequently submitted for intraoperative consultation. Regardless of the high degree of individualized surgical treatment of VCX, some procedures in the handling of vulvectomy specimens can be tailored and might be subject to standardization, including frozen section evaluation. Therefore, all cutaneous vulvar resection margins, and the vaginal, urethral, and anal (mucosal) margin as well as the deep soft tissue margin should also be examined.