AI Article Synopsis
- The study aimed to create a risk assessment tool to help manage pediatric ovarian masses by evaluating the likelihood of cancer before surgery.
- Researchers analyzed data from patients under 18 who had ovarian surgery, focusing on the characteristics of the masses, their size, and tumor markers to estimate malignancy risk.
- Results showed that while simple cysts were benign, 44% of solid tumors and a significant portion of heterogeneous masses with elevated markers were cancerous, leading to recommendations for different surgical approaches based on mass characteristics.
Article Abstract
Purpose: The purpose of this study was to develop a pre-operative risk assessment tool for childhood and adolescent ovarian malignancy, in order to guide operative management of pediatric ovarian masses.
Methods: We conducted a retrospective analysis of patients <18 years old who underwent ovarian surgery at two quaternary care pediatric centers over 4 years (1/1/13-12/31/16). Probability of malignancy was estimated based on imaging characteristics (simple cyst, heterogeneous, or solid), maximal diameter, and tumor markers (α-fetoprotein, β-human chorionic gonadotropin).
Results: Among 188 children with ovarian masses, 11% had malignancies. For simple cysts, there were no malignancies (0/24, 95% CI = 0-17%). Among solid lesions, 44% (15/34, 95% CI = 28-62%) were malignant. Among marker-elevated heterogeneous masses, 40% (2/5, 95% CI = 12-77%) were malignant. Conversely, small (≤10 cm) and large (>10 cm) marker-negative heterogeneous lesions had malignancy proportions of 0% (0/39, 95% CI = 0-11%) and 5% (2/40, 95% CI = 1-18%), respectively.
Conclusions: Given the malignancy estimates identified from these multi-institutional data, we recommend an attempt at ovarian-sparing resection for simple cysts or tumor marker-negative heterogeneous lesions ≤10 cm. Oophorectomy is recommended for solid masses or heterogeneous lesions with elevated markers. Finally, large (>10 cm) heterogeneous masses with non-elevated markers warrant a careful discussion of ovarian-sparing techniques. Complete surgical staging is mandatory regardless of operative procedure.
Type Of Study: Study of Diagnostic Test.
Level Of Evidence: Level I.
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Source |
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| http://dx.doi.org/10.1016/j.jpedsurg.2019.02.019 | DOI Listing |
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