Accuracy of frozen section in borderline ovarian tumor

Borderline ovarian tumor or low malignant ovarian tumor presents in 10-15% of all ovarian cancers, which usually affects younger women and have favorable prognosis even with conservative surgery, in which fertility can be preserved. Lack of reliable diagnostic tool to indicate the type of malignancy before or at the time of surgery makes the borderline ovarian tumor one of the most controversial topics in gynecology. This might lead to many overtreatment cases with radical surgery or undertreatment with conservative surgery with the higher rate of overtreatment compared to under treatment.In this review article, we extensively searched for all reported data regarding the accuracy of frozen section in borderline ovarian tumor. Reviewing the results of six studies, which specifically considered the accuracy of frozen section in borderline ovarian tumors, revealed an accuracy of 60% with an agreement between final pathology and frozen section results. Overall, 24.5% of under-diagnosed malignant cases interpreted to be benign and 4.9% overdiagnosed cases with benign tumor considered as a malignant. Frozen section is a reliable tool to exclude benign tumor from borderline and malignant but underdiagnosed percentage is higher. There are limitations in this review including the small number of enrolled cases, different time of diagnosis and different investigated countries and the discrepancies between the studied articles in this review.