Is there an indication for frozen section examination of the ureteral margins during cystectomy for transitional cell carcinoma of the bladder?: Schumacher MC, Scholz M, Weise ES, Fleischmann A, Thalmann GN, Studer UE, Department of Urology, Institute of

Purpose luated the incidence of pathological findings of the ureter at cystectomy for transitional cell carcinoma of the bladder and assessed the usefulness of intraoperative frozen section examination of the ureter. als and Methods athological findings of ureteral frozen section examination were compared with the corresponding permanent sections, and the diagnostic accuracy of frozen section examination was evaluated. These segments were then compared with the more proximal ureteral segments resected at the level where they cross over the common iliac arteries. The histopathological findings of the ureteral segments were then correlated for upper urinary tract recurrence and overall survival. s tional cell carcinoma or carcinoma in situ was found on frozen section examination of the distal ureter in 39 of 805 patients (4.8%) and on permanent sections in 29 (3.6%). In 755 patients, the false-negative rate of frozen section examination of the ureters was 0.8%. Of the patients with carcinoma in situ diagnosed on the first frozen section examination, 80% also had carcinoma in situ in the bladder. Transitional cell carcinoma or carcinoma in situ in the most proximally resected ureteral segments was found in 1.2% of patients. After radical cystectomy, there was tumor recurrence in the upper urinary tract in 3% of patients with negative ureteral frozen section examination, and in 17% with carcinoma in situ on frozen section examination. sions e frozen section examination of the ureters at radical cystectomy is only recommended for patients with carcinoma in situ of the bladder, provided the ureters are resected where they cross the common iliac arteries.