Comparison of Intraoperative Frozen Section with Preoperative CA125, T.Inhibin and Adenexa IOTA Model in the Surgical Care of Women with Ovarian Tumors in a Tertiary Care Hospital

Aim To compare the accuracy of Frozen section with CA125, T.Inhibin, and Adenexa IOTA score. Design Cross-sectional study. Materials and Methods This study was conducted over a period of 25 months in a tertiary care hospital. Seventy-one patients with diagnosed ovarian mass were enrolled. Presurgical measurement of Ca125 and T.Inhibin serum markers were taken. All the patients were examined by USG and classified into benign and malignant using the Adenexa IOTA score calculator. The intraoperative frozen section was done, and all the three modalities were compared with the final histopathological diagnosis. Result We enrolled 71 patients, the mean age was 50.49. Out of 71 patients, 50 (70.4%) were having a benign tumor, 17 (23.9%) were malignant and four (5.6%) were borderline. The diagnosis by the frozen section had an accuracy of 91.5%. ROC analysis of all the four tests, i.e. Ca125, T.Inhibin, Adenexa Iota, and frozen section were obtained. The area under Roc curve AUC for Frozen section was 0.871 (95% CI 0.776-0.966), for adnexa score was 0.847 (95% CI 0.746-0.948), CA125 was 0.726 (95% CI 0.611-0.840) and for T.Inhibin was 0.432 (95% CI 0.362-0.502). Conclusion Majority of adnexal masses were classified correctly in our study using a frozen section making it best out of four diagnostic tests. Moreover, the frozen section subclassifies both benign and malignant cases, whereas others are dichotomous in prediction. Accuracy of the intraoperative frozen section in ovarian tumors is high making it a reliable option for clinical decision.