Study Objective

To evaluate failure of initial operative therapy (incomplete tumor removal) of ovarian-sparing surgery for pediatric benign ovarian neoplasms.

Methods

A retrospective review of patients up to 21 years of age who underwent ovarian-sparing surgery for a benign ovarian neoplasm from 2010 to 2016 at 8 pediatric hospitals was conducted. Failure of initial operative therapy is defined as a radiologically suspected or pathologically confirmed ipsilateral lesion with the same pathology as the primary neoplasm within 12 weeks of the initial operation.

Results

Forty patients received imaging within 12 weeks of their primary operation. Sixteen (40%) patients had a radiologically identified ovarian abnormality ipsilateral to the primary lesion, and 5 patients were suspected to have the same lesion as their primary neoplasm. Three of the 5 patients (7.5%) underwent reoperation with pathologic confirmation of the same lesion, resulting in a pathologically confirmed failure of therapy rate of 7.5%. The other 2 patients had serial imaging that subsequently demonstrated no recurrence with lesion resolution. Age, race/ethnicity, laparoscopy vs laparotomy, presence of torsion, pathology, size of lesion, and surgeon specialty were not associated with failure of therapy.

Conclusion

In most patients who received imaging within 12 weeks of the primary operation for resection of a benign ovarian neoplasm, ovarian-sparing surgery was successful in complete tumor removal, with a low failure of therapy rate. Selected patients with suspected failure of therapy on initial imaging could be serially monitored to determine the need for repeat surgical intervention.

中文翻译：

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小儿良性卵巢肿瘤保留卵巢手术后手术治疗失败的回顾性研究

学习目标

评估小儿良性卵巢肿瘤的保留卵巢手术的初始手术治疗（不完全切除肿瘤）的失败。

方法

对 2010 年至 2016 年在 8 家儿科医院接受良性卵巢肿瘤保留卵巢手术的 21 岁以下患者进行了回顾性分析。初始手术治疗失败定义为在初始手术后 12 周内放射学怀疑或病理证实与原发肿瘤具有相同病理学的同侧病变。

结果

40 名患者在初次手术后 12 周内接受了影像学检查。16 名 (40%) 患者在放射学上发现与原发性病变同侧的卵巢异常，5 名患者被怀疑与其原发性肿瘤具有相同的病变。5 例患者中有 3 例 (7.5%) 接受了再次手术，病理证实为同一病变，导致病理证实的治疗失败率为 7.5%。其他 2 名患者进行了连续影像学检查，随后证明病灶消退后没有复发。年龄、种族/民族、腹腔镜检查与开腹手术、是否​​存在扭转、病理学、病变大小和外科医生专业与治疗失败无关。

结论

大多数在初次手术切除良性卵巢肿瘤后 12 周内接受影像学检查的患者，保留卵巢手术成功地完全切除了肿瘤，治疗失败率较低。可以对初始成像怀疑治疗失败的选定患者进行连续监测，以确定是否需要重复手术干预。