Influence of Intraoperative Capsule Rupture on Outcomes in Stage I Epithelial Ovarian Cancer

Bakkum-Gamez, Jamie N.; Aletti, Giovanni; Cliby, William A.

doi:10.1097/aog.0b013e3181ac3e03

Cited by 5 publications

(5 citation statements)

References 20 publications

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“…This increases the risk of spilling cyst fluid containing malignant cells into the peritoneal cavity (44). Previous studies clearly showed that rupture of a malignant ovarian cyst worsens the prognosis for diseasefree survival in stage I invasive ovarian cancers (2,3). Spilling should also probably be avoided in borderline tumors, even though there are no prospective studies to prove this (44).…”

Section: Discussionmentioning

confidence: 99%

“…Benign masses can be managed conservatively or-if technically feasible-be removed by laparoscopy. However, patients with masses that are presumed to be malignant should be referred to gynecologic oncologists for proper staging and debulking (1)(2)(3). A mistake in either direction could worsen the patient's prognosis or create unnecessary anxiety, cost, and extensive surgery.…”

Section: Introductionmentioning

confidence: 99%

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External Validation of Diagnostic Models to Estimate the Risk of Malignancy in Adnexal Masses

Holsbeke

Calster

Bourne

et al. 2012

Clinical Cancer Research

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Purpose: To externally validate and compare the performance of previously published diagnostic models developed to predict malignancy in adnexal masses.Experimental Design: We externally validated the diagnostic performance of 11 models developed by the International Ovarian Tumor Analysis (IOTA) group and 12 other (non-IOTA) models on 997 prospectively collected patients. The non-IOTA models included the original risk of malignancy index (RMI), three modified versions of the RMI, six logistic regression models, and two artificial neural networks. The ability of the models to discriminate between benign and malignant adnexal masses was expressed as the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and likelihood ratios (LR þ , LR À ). Results: Seven hundred and forty-two (74%) benign and 255 (26%) malignant masses were included. The IOTA models did better than the non-IOTA models (AUCs between 0.941 and 0.956 vs. 0.839 and 0.928). The difference in AUC between the best IOTA and the best non-IOTA model was 0.028 [95% confidence interval (CI), 0.011-0.044]. The AUC of the RMI was 0.911 (difference with the best IOTA model, 0.044; 95% CI, 0.024-0.064). The superior performance of the IOTA models was most pronounced in premenopausal patients but was also observed in postmenopausal patients. IOTA models were better able to detect stage I ovarian cancer.Conclusion: External validation shows that the IOTA models outperform other models, including the current reference test RMI, for discriminating between benign and malignant adnexal masses. Clin Cancer Res; 18(3); 815-25. Ó2011 AACR.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

External Validation of Diagnostic Models to Estimate the Risk of Malignancy in Adnexal Masses

Holsbeke

Calster

Bourne

et al. 2012

Clinical Cancer Research

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“…Intraoperative tumor spill is also taken as IC disease even when the tumor is confined to one ovary according to FIGO staging and hence all attempts should be made during surgery to deliver the tumor without spillage. There is varying reports on the risk of tumor spillage on patient survival, some authors reporting poorer survival after tumor spillage, while others contradicting the same [13][14][15][16].…”

Section: Ovarian Cancermentioning

confidence: 99%

Fertility Sparing Surgery in Gynecologic Cancer

Rema

Ahmed

2014

J Obstet Gynecol India

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Fertility preservation is one of the major concerns of young patients diagnosed with gynecological cancer. With newer treatment regimens and better surgical techniques, survival rates after cancer treatment have improved, hence preservation of fertility has recently become an important issue in the treatment of gynecological cancers. Fertility sparing surgery may be an option for early-stage cervical cancer with the development of loop excision techniques and radical trachelectomy which allows a radical approach to cervix cancer at the same time preserving the uterus and thus fertility. Fertility preservation is possible in Stage 1 epithelial ovarian cancers, germ cell ovarian tumors, and borderline cancers. Hormonal therapy with progestin agents is effective in early endometrial cancer. In patients desiring future pregnancy, fertility sparing options must be explored before starting treatment for gynecologic cancers.

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“…However, cystic rupture and spillage occurred in 121 cases [32]. The implications of a ruptured benign cyst are negligible, but rupture of a stage I ovarian malignancy results in an increase in stage and may lead to a worse disease-free survival [33].…”

Section: Minimally Invasive Surgerymentioning

confidence: 99%

Evaluation and Management of Women Presenting with a Pelvic Mass

MacLaughlan

Cronin

Moore

2012

Curr Obstet Gynecol Rep

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Management of women with a pelvic mass is a very common scenario for gynecologists. Often these are benign masses that can either be observed or managed with straightforward laparoscopic surgery, but complex, potentially malignant masses require careful consideration and triaging for appropriate care. This article aims to outline the presentation, management, and triage guidelines for women presenting with an ovarian cyst or pelvic mass. We discuss data surrounding the use of triage guidelines, as well as the role of promising biomarkers that can assist in better predicting benign versus malignant pathology.

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Influence of Intraoperative Capsule Rupture on Outcomes in Stage I Epithelial Ovarian Cancer

Abstract: OBJECTIVE:To evaluate the effect of tumor capsule rupture on disease prognosis in stage I epithelial ovarian cancer. METHODS: All patients with International Federation of

Cited by 5 publications

References 20 publications

External Validation of Diagnostic Models to Estimate the Risk of Malignancy in Adnexal Masses

External Validation of Diagnostic Models to Estimate the Risk of Malignancy in Adnexal Masses

Fertility Sparing Surgery in Gynecologic Cancer

Evaluation and Management of Women Presenting with a Pelvic Mass

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