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- W2108806964 abstract "Preoperative evaluation of ovarian tumors is essential to determine appropriate treatment. Benign ovarian tumors undergo an ovarian sparing surgery to preserve fertility while malignant lesions undergo oophorectomy. Our study assesses the utility of gonadal volumes and tumor markers to evaluate the risk of malignancy. Retrospective chart review. Female patients (8-18 years) who had an ovarian operation from January 2008 to December 2012 were included. Demographics, preoperative ultrasonographic gonadal measurements, and tumor markers were collected. Volumes were calculated with the prolate ellipsoid formula. Data are presented as medians. 123 females at a median age of 13.7 years (IQR 12.5-16 years) were included. 115 girls had benign pathology and 8 had malignant pathology. All patients with malignant pathology had an oophorectomy. Of those with benign pathology, 22 patients had an oophorectomy and 93 patients underwent ovarian sparing surgery. The benign lesion volume was significantly smaller than the malignant lesion volume and beta-HGC, AFP, and LDH were less likely to be elevated. There was no difference in ovarian volume ratio between malignant and benign pathology.Tabled 1Gonadal measurements and tumor markers based on ovarian pathologyMalignant (N=8)Benign (N=115)p-valueVolume of ovarian lesion (cm3 [/sup]) (Median, (IQR))1548(627-2105)152(57-592)0.001Ratio of affected ovarian volume to expected ovarian volume (age based) (Median, (IQR))1.4(1.5-16)5.8(1.1-1.7)0.242Ratio of affected ovarian volume to contralateral normal ovarian volume (Median, (IQR))2.61.7(0.7-7.2)0.907Elevated beta-HCG (N,(%))2/5(40)0/44(0)<0.001Elevated AFP (N,(%))3/5(60)1/48(2)<0.001Elevated LDH (N,(%))2/3(67)2/25(8)0.006Elevated CA-125 (N,(%))2/4(50)5/22(23)0.258 Open table in a new tab A ROC curve analysis of lesion volume to malignancy (AUC 0.84, p=0.001) revealed a threshold volume of <184 cm3 (100% sensitivity, 54% specificity, NPV 100%, PPV 13%) to screen for malignancy. This held true when applied to our dataset. Of 62 girls with volumes <184 cm3, none had malignant pathology. This study reveals the novel use of ovarian volumes as a potential preoperative screening method to define candidates for ovarian sparing surgery. Ovarian volumes <184 cm3 are more predictive of benign disease. Further validation and correlation with laboratory parameters is warranted." @default.
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- W2108806964 date "2014-09-01" @default.
- W2108806964 modified "2023-09-27" @default.
- W2108806964 title "Ovarian lesions volumes as a screen for malignancy in pediatric ovarian tumors" @default.
- W2108806964 doi "https://doi.org/10.1016/j.fertnstert.2014.07.249" @default.
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