Surgical evaluation and management of adnexal masses: A tertiary care center experience

Yasin Duran 1, Batuhan Üstün 2, *, Fırat Can Söğüt 2, Özlem Sevinç Ergül 2, R Ceren Avcı Çavdar 2 and Mehmetbaki Şentürk 2

1 Namık Kemal University Hospital, Department of General Surgery, Tekirdağ, Turkey.
2 Namık Kemal University Hospital, Department of Gynecology and Obstetrics, Tekirdağ, Turkey
 
Research Article
World Journal of Advanced Research and Reviews, 2021, 09(01), 207-211
Article DOI: 10.30574/wjarr.2021.9.1.0016
 
Publication history: 
Abstract: 
Introduction: Intraoperative and postoperative outcomes of ovarian carcinoma patients who underwent cytoreductive surgery in our clinic has been evaluated with the measures of adjuvant chemotherapy requirement, recurrence and survival rates. 
Materials and methods: Cases who underwent cytoreductive surgery between 2018-2019 in our clinic are evaluated in aspects of age at diagnosis, menopausal status, pathological stage of tumor, size of tumor, mode of surgical therapy, duration of surgery, neoadjuvant/adjuvant therapy choice, follow-up protocol, synchronous/metachronous state, rate of relapses and survival.
Results and discussion: The mean age of total 23 operated cases is 59±8.9. %69,6 of all cases is found to be primary ovarian carcinoma, whereas %30,4 is ovarian metastasis of other malignancies. Among metastatic cases, three is primary carcinoma of colon, one is gastric cancer and one is primary carcinoma of bladder. In other two cases, invasion of endometrial cancer to the ovary was observed. In addition to the standard surgical procedures, one case has undergone diagnostic mass resection, one sole total abdominal hysterectomy (TAH) and bilateral salpingooferectomy (BSO) and 21 omentectomy (OMT). Among these 21 cases one has undergone bilateral pelvic lymph node dissection and five (%21,7) bilateral pelvic paraaortic lymph node dissection (BPPLND). In addition to TAH, BSO, OMT and BPPLND; nine (%39,1) cases has undergone low anterior resection, one cystectomy, one distal pancreas resection and one partial gastrectomy. Three (%13) of the cases has been diagnosed in stage 1, one in stage 2, nine (%39,1) in stage 3 and ten (%43,5) in stage 4. Four (%17,4) of the cases had taken neoadjuvant chemotherapy priorly to the surgery. Twenty-one (%91,3) of the cases took adjuvant chemotherapy and one chemoradiotherapy. Relapses has been observed in the follow up of two (%8,7) cases. Nineteen (%82,6) of the cases are currently in disease-free state and four (%17,4) has been in exitus state.
Conclusion: Surgery is the major modality of treatment in ovarian cancer. Various surgical resections by experienced gynecologists may be in need to achieve optimal cytoreduction and multidisciplinary approach is substantially important.
 
Keywords: 
Anterior resection; Ovarian tumor; Survival rate; Cytoreduction
 
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