Factors affecting recurrence after surgery for ovarian mature cystic teratoma

Abstract

We aimed to evaluate the risk factors for recurrence of surgically managed ovarian mature cystic teratoma (MCT). A total of 178 women with MCT managed surgically at our clinic were included in this retrospective study. The cases were followed for a minimum of 34 months. Risk factors recorded were age, gravidity, diameter of MCT, tumour markers, bilaterality, operation time and recurrence time. One hundred forty-one women (79.2%) underwent laparoscopy and the other thirty-seven patients (20.8%) underwent laparotomy. The mean age of patients with cyst recurrence was significantly lower than that of patients without recurrence (p = 0.02). There was a significantly lower median gravidity and parity in this group. The capacity of younger age, lower gravidity and parity in predicting the recurrence of ovarian MCT was analysed using receiver operating characteristic curve analysis. The cut-off value of age, number of gravidity and parity was 26, 1 and 0, respectively. In conclusion, younger age and lower gravidity and parity were predictive of recurrence due to a more conservative approach in young and nulliparous patients. Therefore, we suggest regular follow-up visits during the postoperative period, especially for younger patients and those with lower numbers of gravidity and parity.

Lessons From a Large Nationwide Study of 350 Children With Ovarian Mature Teratoma: A Plea for Ovarian-Sparing Surgery

“…Laparoscopy has the advantages of decreasing postoperative pain, complications, and length of hospitalization (6,8,20,22,25). It also minimizes postoperative adhesions, which may have an impact on fertility (6,7,24). All of these benefits promote laparoscopy as the first surgical approach in adults (6,20,21).…”

“…These benign germ cell tumors (GCTs) are characterized by differentiated tissue types originating from 2 to 3 germ cell lineages -the ectoderm, mesoderm and endoderm (2). OMTs represent the most common benign neoplasms among pediatric GCTs, reported in 70% of females under 30 years of age and making up 30% to 50% of all pediatric adnexal lesions (3)(4)(5)(6)(7)(8)(9)(10). Even if unilateral OMTs are the most frequent situation at diagnosis, OMT can present as multifocal on ipsi-or contralateral ovaries.…”

“…Treatment relies on surgery with the aim of obtaining complete tumor resection without recurrence. Nevertheless, the ovarian parenchyma must be preserved when preoperative work-up is consistent with a diagnosis of a benign lesion such as OMT (7). Imaging, particularly MRI plays key role in collecting evidence for the benign nature of the lesion, such as the presence of fat, liquid and calcifications (7,11).…”

“…Nevertheless, the ovarian parenchyma must be preserved when preoperative work-up is consistent with a diagnosis of a benign lesion such as OMT (7). Imaging, particularly MRI plays key role in collecting evidence for the benign nature of the lesion, such as the presence of fat, liquid and calcifications (7,11). When lesions have large volumes (above 20 cm 3 or 8 cm), notable vascularization, intratumoral septations, papillary projections, heterogeneity or solid tissue echogenicity, ascites, or nodal/distant metastasis, the OMT diagnosis should be questioned, and the specialist should be alerted to a potential malignant tumor (2,6,9,(11)(12)(13).…”

Untitled

“…5 Los teratomas quísticos maduros, también llamados quistes dermoides (por la frecuente aparición de estructuras relacionadas con la piel en estos quistes) 7 , son tumores de células germinales de los ovarios que se originan a partir de tres capas, el ectodermo, el mesodermo y el endodermo. 8 Son las neoplasias ováricas más comunes, que representan el 30% de los tumores benignos de ovario. 9,10,11 Rara vez son grandes, generalmente miden <10 cm.…”