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• W2897446918 abstract "To assess the incidence of malignant outcomes in postmenopausal patients with a presumed benign adnexal mass during the first 2 years of conservative management and balance it with the risk of complications had all masses been surgically removed. The interim analysis of IOTA5, a multicentre international prospective cohort study, analysed conservative follow-up in patients with an adnexal tumour judged to be benign and who were eligible for conservative management according to the ultrasound examiner. Patients were recruited consecutively from Feb 2012 to Mar 2015; median follow-up 27 months. Main endpoints were the cumulative incidence of surgical intervention and the diagnosis of invasive malignancy on histopathology. Here, we focus on results for postmenopausal patients, and related this to results from the UKCTOCS and PLCO trials. The analysis included 825 patients undergoing follow-up. The cumulative incidence of surgery within 2 years was 12.7% (95% CI 10.3-15.0%) and the cumulative incidence of invasive adnexal malignancy was 0.7% (95% CI 0.1-1.3). Five patients had primary ovarian cancer (three stage I and two stage III); one had a metastatic bowel cancer. Surgery in the six patients was performed 1-6 months after inclusion. All six patients are still alive. In the UKCTOCS and PLCO trial, severe surgical complications were reported in 3.5% and 15%, respectively. Applying this to our cohort, if all our patients had undergone surgery, a theoretical additional 25 to 108 patients would have suffered major surgical complications. Conservative management of postmenopausal patients with benign-looking adnexal masses resulted in few cases of malignant outcome and short delay in malignant diagnosis. The risks of worsening the prognosis for women with a malignancy with conservative management of presumably benign masses seem to be small compared to the theoretical risk of complications if surgery would have been performed on all." @default.
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• W2897446918 date "2018-10-01" @default.
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• W2897446918 title "OC01.02: Balancing risks of surgery with risks of conservative management of benign adnexal masses: results from the postmenopausal follow-up arm of IOTA5" @default.
• W2897446918 doi "https://doi.org/10.1002/uog.19208" @default.
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