Laparoscopic findings during adnexal surgery in women with a history of nongynecologic malignancy

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• 作者：Margrit M. Juretzka ; Cimberly L. Crawford ; Christine Lee ; Andrew Wilton ; Samer Schuman ; Dennis S. Chi ; Yukio Sonoda ; Richard R. Barakat and Nadeem R. Abu-Rustum
• 刊名：Gynecologic Oncology
• 出版年：2006
• 出版时间：May 2006
• 年：2006
• 卷：101
• 期：2
• 页码：327-330
• 全文大小：85 K

文摘

Objectives.

To describe the results of laparoscopic management of adnexal masses in women with a history of nongynecologic malignancy.

Methods.

We conducted a retrospective review of 262 patients with history of prior nongynecologic malignancy who underwent laparoscopy for management of an adnexal mass between 1/1992 and 6/2004.

Results.

Median patient age at laparoscopy was 55 years (range, 20–91 years), and median BMI was 25 kg/m² (range, 14–41 kg/m²). Of the 262 patients, 145 (55.3 % ) had prior abdominal/pelvic surgery. Prior cancer history included breast (202, 77.1 % ), lymphoma/leukemia (16, 6.1 % ), colorectal (8, 3.0 % ), lung (7, 2.7 % ), multiple myeloma (5, 1.9 % ), head/neck (5, 1.9 % ), genitourinary (5, 1.9 % ), upper gastrointestinal (4, 1.5 % ), and other (10, 3.8 % ). Median ovarian mass diameter measured on radiologic imaging was 3.8 cm (range, 0.2–13.5 cm); median CA-125 was 17.0 U/mL (range, 1–7000 U/mL). In all, 49 (18.7 % ) patients had malignancy identified at laparoscopy, with 30/49 (61.2 % ) diagnosed with metastatic malignancy to the ovary and 19/49 (38.8 % ) having a new primary ovarian malignancy. Median tumor diameter and CA-125 were significantly higher in women found to have a malignancy (4.7 vs. 3.7 cm, and 35 vs. 14 U/mL, respectively). Overall, conversion to laparotomy occurred in 34 (12.9 % ) cases. Twenty-one of 49 (42.9 % ) patients with malignancy were converted to laparotomy compared with 13/213 (6.1 % ) when benign disease was noted (P < 0.001).

Conclusions.

Approximately 1 in 5 patients with a history of nongynecologic malignancy who were selected for laparoscopic management of an adnexal mass was found to have malignancy, with 60 % being metastatic from other primaries. The majority of cases were managed laparoscopically even if malignancy was identified.