| Surgical management of a suspicious adnexal mass: A systematic review. | |
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MedLine Citation:
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PMID: 22522189 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: To systematically review the existing literature in order to determine the optimal recommended protocols for the surgical management of adnexal masses suspicious for apparent early stage malignancy. METHODS: A review of all systematic reviews and guidelines published between 1999 and 2009 was conducted as a first step. After the identification of two systematic reviews on the topic, searches of MEDLINE for studies published since 2004 was also conducted to update and supplement the evidentiary base. RESULTS: The updated literature search identified 31 studies that met the inclusion criteria. A bivariate random effects analysis of 15 frozen section diagnosis studies yielded an overall sensitivity of 89.2% (95% CI, 86.3 to 91.5%) and specificity of 97.9% (95% CI, 96.6 to 98.7%). The surgical evidence suggests that systematic lymphadenectomy and proper surgical staging improve survival. Conservative fertility-preserving surgical approaches are an acceptable option in women with low malignant potential tumours. The accuracy and adequacy of surgical staging by laparotomy or laparoscopic approaches appears to be comparable, with neither approach conferring a survival advantage. Intraoperative tumour rupture was indeed reported to occur more frequently in patients undergoing laparoscopy versus laparotomy in two retrospective cohort studies. CONCLUSIONS: The best available evidence was collected and included in this rigorous systematic review. The abundant evidentiary base provided the context and direction for the surgical management of adnexal masses suspicious for apparent early stage malignancy. |
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Authors:
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Allan L Covens; Jason E Dodge; Christina Lacchetti; Laurie M Elit; Tien Le; Michaela Devries-Aboud; Michael Fung-Kee-Fung; |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-4-18 |
Journal Detail:
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Title: Gynecologic oncology Volume: - ISSN: 1095-6859 ISO Abbreviation: - Publication Date: 2012 Apr |
Date Detail:
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Created Date: 2012-4-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0365304 Medline TA: Gynecol Oncol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012. Published by Elsevier Inc. |
Affiliation:
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Division of Gynecologic Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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