Sarah Braungart1, Ross J Craigie2, Paul Farrelly2, Paul D Losty3. 1. Department of Paediatric Surgery, Royal Manchester Children's Hospital, Manchester, UK; Department of Paediatric Surgery, Alder Hey Children's Hospital, Liverpool, UK. Electronic address: sarah.braungart@doctors.org.uk. 2. Department of Paediatric Surgery, Royal Manchester Children's Hospital, Manchester, UK. 3. Department of Paediatric Surgery, Alder Hey Children's Hospital, Liverpool, UK; University of Liverpool, Liverpool L69 3BX, UK.
Abstract
BACKGROUND: Ovarian tumors in the pediatric age group are rare. A significant number of children with ovarian mass lesions present "out of hours "as surgical emergencies, and surgical management does not always involve a surgical oncologist. This multicenter study reports how the mode of clinical presentation may influence (i) operation (conventional open vs minimally invasive surgery (MIS)) and (ii) examines if young females presenting as surgical emergency(s) are more likely to undergo total oophorectomy or ovarian sparing surgery. METHODS: Retrospective multicenter study amongst UK pediatric surgical oncology centers. Females <16 years with diagnosis of ovarian tumor from 2006 to 2016 were included. Functional/neonatal ovarian cysts were excluded. RESULTS: Three hundred ten patients with ovarian tumors treated at 12 surgical oncology centers were identified. Mean age at surgery was 11 years [IQR 8-14]. Most common diagnosis were mature teratoma (57%, 177 cases), immature teratoma (10.9%, 34 cases) and cystadenoma (12%, 36 cases). Seventy percent (217) of cases were performed as open procedures. Thirty percent (94) of children underwent MIS. Tumors were significantly smaller in children who underwent MIS. Median tumor size in the laparoscopic group was 6 cm compared to 11 cm in the open group (p < 0.00001). Children who underwent MIS were significantly more likely to have ovary sparing surgery. CONCLUSION: This UK nationwide study demonstrates that ovary-sparing surgery and minimally invasive surgery are still infrequently deployed by pediatric surgeons in the UK. Patients with smaller tumors were more likely to undergo MIS, and more frequently underwent ovary-sparing surgery. In view of the implications on fertility and hormonal health caused by unilateral oophorectomy, it is time to review this current practise and agree consensus guidelines to reduce rates of unnecessary oophorectomy. LEVEL OF EVIDENCE STATEMENT: This is a level II evidence study. It is a retrospective multicentre collaborative study, which summarizes data from a national cohort of children.
BACKGROUND:Ovarian tumors in the pediatric age group are rare. A significant number of children with ovarian mass lesions present "out of hours "as surgical emergencies, and surgical management does not always involve a surgical oncologist. This multicenter study reports how the mode of clinical presentation may influence (i) operation (conventional open vs minimally invasive surgery (MIS)) and (ii) examines if young females presenting as surgical emergency(s) are more likely to undergo total oophorectomy or ovarian sparing surgery. METHODS: Retrospective multicenter study amongst UK pediatric surgical oncology centers. Females <16 years with diagnosis of ovarian tumor from 2006 to 2016 were included. Functional/neonatal ovarian cysts were excluded. RESULTS: Three hundred ten patients with ovarian tumors treated at 12 surgical oncology centers were identified. Mean age at surgery was 11 years [IQR 8-14]. Most common diagnosis were mature teratoma (57%, 177 cases), immature teratoma (10.9%, 34 cases) and cystadenoma (12%, 36 cases). Seventy percent (217) of cases were performed as open procedures. Thirty percent (94) of children underwent MIS. Tumors were significantly smaller in children who underwent MIS. Median tumor size in the laparoscopic group was 6 cm compared to 11 cm in the open group (p < 0.00001). Children who underwent MIS were significantly more likely to have ovary sparing surgery. CONCLUSION: This UK nationwide study demonstrates that ovary-sparing surgery and minimally invasive surgery are still infrequently deployed by pediatric surgeons in the UK. Patients with smaller tumors were more likely to undergo MIS, and more frequently underwent ovary-sparing surgery. In view of the implications on fertility and hormonal health caused by unilateral oophorectomy, it is time to review this current practise and agree consensus guidelines to reduce rates of unnecessary oophorectomy. LEVEL OF EVIDENCE STATEMENT: This is a level II evidence study. It is a retrospective multicentre collaborative study, which summarizes data from a national cohort of children.
Authors: Justyna Łuczak; Maciej Bagłaj; Piotr Dryjański; Alicja Kalcowska; Nastazja Banaszyk-Pucała; Maria Boczar; Krzysztof Dymek; Małgorzata Fryczek; Kaja Giżewska-Kacprzak; Wojciech Górecki; Andrzej Grabowski; Anna Gregor; Maria Jabłońska; Grzegorz Kowalewski; Magdalena Lewandowska; Maria Małowiecka; Anna Ogorzałek; Magdalena Pękalska; Aneta Piotrowska-Gall; Mateusz Porębski; Marek Siewiński; Dariusz Patkowski Journal: Curr Oncol Date: 2022-02-28 Impact factor: 3.677
Authors: Gun Gu Kang; Kyeong A So; Ji Young Hwang; Nae Ri Kim; Eun Jung Yang; Seung Hyuk Shim; Sun Joo Lee; Tae Jin Kim Journal: Sci Rep Date: 2022-03-10 Impact factor: 4.379