Trends in Intraoperative Frozen Section Diagnosis: A 20-Year Cohort Study at a Tertiary Health Care Centre

Intraoperative frozen section consultation serves as an essential tool for guiding optimal surgical management. This study investigated generational changes in the utilization of intraoperative frozen section over the past two decades in a tertiary healthcare center. Pathology reports of patients who underwent intraoperative frozen section analysis at Kaohsiung Medical University Hospital between 2001 and 2020 were reviewed and categorized according to anatomic site. The number and distribution of intraoperative frozen section cases across various anatomic sites were analyzed over the past two decades. The proportions of frozen section for each anatomical site were compared between the periods 2001–2010 and 2011–2020. In the first decade, 8,958 frozen sections were evaluated, accounting for 3.8% of all surgical specimens. Breast tissue constituted the most common specimen submitted for frozen section analysis, followed by tissues from the central nervous system and lungs. In the second decade, 12,156 frozen sections were obtained, accounting for 4.4% of all surgical specimens. Breast tissue remained the most frequently analyzed sample, followed by tissues from the lung and female genital system. Between the two decades, the proportion of frozen section significantly decreased for the thyroid, urinary tract, and soft tissue/bone. Conversely, the proportion significantly increased for specimens from the lung, oral cavity, female genital system, and skin. Regular evaluations are essential to prevent overuse and ensure adherence to current evidence-based practices. Further improvements in diagnostic accuracy, revision of practice guidelines, resource allocation, and adjustment of training programs are warranted.