Laparoscopic Approach to Ovarian Mass in Children and Adolescents: Already a Standard in Therapy

Mayer, Jan; Bettolli, Marcos; Kolberg-Schwerdt, Andreas; Lempe, Michael; Schlesinger, Frank; Hayek, Irina; Schaarschmidt, K.

doi:10.1089/lap.2008.0191

Cited by 20 publications

(29 citation statements)

References 13 publications

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“…Performance of laparoscopy as minimally invasive surgery can be useful for both diagnosis and treatment. Mayer and colleagues previously suggested that laparoscopy is associated with satisfactory outcomes and few complications (Mayer et al, 2009). We also generally preferred laparoscopy for the surgical treatment and performed cystectomy in the majority of patients.…”

Section: Figure 1 Roc Curve Analysis For Plr In Prediction Of Adolesmentioning

confidence: 99%

Value of the Platelet to Lymphocyte Ratio in the Diagnosis of Ovarian Neoplasms in Adolescents

Özakşit

Tokmak²,

Kalkan³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: Relationships between poor prognosis of ovarian malignancies and changes in complete blood count parameters have been proposed previously. In this work, we aimed to evaluate clinicopathologic features in adolescents with adnexal masses and sought to establish any predictive value of the platelet to lymphocyte ratio (PLR) in diagnosis. Materials and Methods: This retrospective study was conducted on 196 adolescent females with adnexal masses. Three groups were constituted with respect to clinical or histopathology results: group 1, non-neoplastic patients (n:65); group 2, neoplastic patients (n:68); and group 3 expectantly managed patients (n:63). The main parameters recorded from the hospital database and patient files were age, body mass index (BMI), chief symptoms, diameter of the mass (DOM), tumor marker levels, complete blood count values including absolute neutrophil, lymphocyte, and platelet counts, mean platelet volume, platelet distribution width, and platecrit, surgical features, and postoperative histopathology results. Results: The expectantly managed patients were younger than the other groups (p=0.007). The mean body mass index (BMI) was higher in the neoplastic group (p=0.016). Preoperative DOM, CA125, mean platelet volume and PLR were statistically significantly different between the groups (p<0.05). ROC curve analysis demonstrated that increased PLR (AUC, 0.609; p=0.011) and BMI (AUC, 0.611; p=0.011) may be discriminative factors in predicting ovarian neoplasms in adolescents preoperatively. When the cut-off point for the PLR level was set to 140, the sensitivity and specificity levels were found to be 65.7% and 57.6%, respectively. Conclusions: We suggest that beside a careful preoperative evaluation including clinical characteristics, ultrasonographic features and tumor markers, PLR may predict ovarian neoplasms in adolescents.

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Section: Figure 1 Roc Curve Analysis For Plr In Prediction Of Adolesmentioning

confidence: 99%

Value of the Platelet to Lymphocyte Ratio in the Diagnosis of Ovarian Neoplasms in Adolescents

Özakşit

Tokmak²,

Kalkan³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…In contrast, laparoscopic surgery has been widely recognized as the gold standard in the management of adnexal masses for which malignancy can be excluded preoperatively (Mayer et al, 2009;Seckin et al, 2011). However, even when strict criteria are used to limit the use of laparoscopic surgery to those patients whose masses are most likely to be benign, some patients who undergo laparoscopic surgery are intraoperatively or post-operatively determined to have malignant tumors (Muzii et al, 2005), a scenario known as unexpected ovarian malignancy.…”

Section: Introductionmentioning

confidence: 99%

Unexpected ovarian malignancy following laparoscopic excision of adnexal masses

et al. 2014

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main results and the role of chance: A total of 1128 adnexal masses were resected, and 13 patients (1.5%) had ovarian malignancies: 6 ovarian cancer (1 mucinous, 1 endometrioid G1, 1 granulosa cell and 3 carcinoid) and 7 borderline tumors (BOTs; 5 mucinous and 2 serous). Of these, two patients with mucinous BOTs underwent fertility-sparing surgery and six patients underwent staging laparotomy. Due to cyst rupture during surgery, nine patients (69.2%) were upgraded to tumor stage IC. Secondary surgeries were performed in eight patients, with a mean interval of 88.9 days (range, 39 -182 days) between the surgeries. All patients were alive and without evidence of disease at follow-up (mean follow-up, 38 months; range, 6 -80 months).limitations, reasons for caution: This was a retrospective study with a small case number and a short follow-up period. wider implications of the findings: The presence of an early-stage unexpected ovarian malignancy did not alter the patient's prognosis, even if there was a significant delay in surgical staging after the finding of an unexpected malignancy during laparoscopy.

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“…In recent years, laparoscopic surgery has been accepted as the gold standard in the management of adnexal masses in gynecologic surgery and its advantages have been well documented in large adult series. 7 Also, there has been a notable shift from open surgery to laparoscopic approach in young females. 8 Minimally invasive surgery in this age group is especially important for future fertility.…”

Section: Introductionmentioning

confidence: 99%

“…However, there are small series describing the efficacy and safety of laparoscopy for ovarian lesions in the adolescent and young adult population. 1e3, 7 The present study tried to investigate the laparoscopic management of ovarian masses in adolescents and young adults and review our experience about this subject.…”

Section: Introductionmentioning

confidence: 99%