Analysis of the factors determining the type of surgical procedure in mature cystic teratomas
Abstract
Objectives: It was aimed to evaluate which factors determine the surgical procedure selected by surgeons for cases with mature cystic teratoma (MCT).
Material and methods: This study included 50 cases with histopathologically proven MCT between January 2011 and August 2016 at a tertiary reference hospital. Data related to demographic and clinical characteristics were retrieved from medical records. Multivariate logistic regression analysis was conducted to evaluate the independent factors determining the type of surgical procedure to be applied.
Results: A higher rate of patients with large cyst size and elevated CA 19-9 was determined in the postmenopausal patients compared to the premenopausal patients (p = 0.033, p = 0.035). Cystectomy and oopherectomy were applied to 72.55% and 27.5% of the cases respectively. No recurrence in the operated ovary was observed in the 1-year follow-up period in any of the cystectomy cases. The major and only independent variable for the preference of cystectomy over oopherectomy was found to be a younger age (≤ 40 years). There was no independent variable which predicted the selection of laparoscopy or laparotomy by surgeons.
Conclusions: Cystectomy was seen to be preferred by surgeons in the majority of MCT patients aged ≤ 40 years regardless of the size of the cyst. This is plausible since these patients have greater concerns about future fertility compared to patients > 40 years old. No recurrence was detected in any of the cystectomy cases, which strengthens the feasibility of this procedure. No serious complications developed in laparoscopy which could render it a safe option for undertaking cystectomy/oopherectomy in MCT cases.
Keywords: cystectomymature cystic teratomaoopherectomy
References
- Ozgur T, Atik E, Silfeler DB, et al. Mature cystic teratomas in our series with review of the literature and retrospective analysis. Arch Gynecol Obstet. 2012; 285(4): 1099–1101.
- Ayhan A, Bukulmez O, Genc C, et al. Mature cystic teratomas of the ovary: case series from one institution over 34 years. Eur J Obstet Gynecol Reprod Biol. 2000; 88(2): 153–157.
- Frimer M, Seagle BLL, Chudnoff S, et al. Role of elevated cancer antigen 19-9 in women with mature cystic teratoma. Reprod Sci. 2014; 21(10): 1307–1311.
- Chen JM, Gao HY, Wang Q, et al. Expression and clinical significance of tumor markers in ovarian mature cystic teratoma. Clin Exp Obstet Gynecol. 2016; 43(3): 397–400.
- Coskun A, Kiran G, Ozdemir O. CA 19-9 can be a useful tumor marker in ovarian dermoid cysts. Clin Exp Obstet Gynecol. 2008; 35(2): 137–139.
- Kondo W, Bourdel N, Cotte B, et al. Does prevention of intraperitoneal spillage when removing a dermoid cyst prevent granulomatous peritonitis? BJOG. 2010; 117(8): 1027–1030.
- Shawki O, Ramadan A, Askalany A, et al. Laparoscopic management of ovarian dermoid cysts: potential fear of dermoid spill, myths and facts. Gynecological Surgery. 2007; 4(4): 255–260.
- Comerci JT, Licciardi F, Bergh PA, et al. Mature cystic teratoma: a clinicopathologic evaluation of 517 cases and review of the literature. Obstet Gynecol. 1994; 84(1): 22–28.
- Ugur MG, Ozturk E, Balat O, et al. Do high levels of CA 19-9 in women with mature cystic teratomas of the ovary warrant further evaluation? Eur J Gynaecol Oncol. 2012; 33(2): 207–210.
- Cho Hy, Kim K, Jeon YT, et al. CA19-9 elevation in ovarian mature cystic teratoma: discrimination from ovarian cancer - CA19-9 level in teratoma. Med Sci Monit. 2013; 19: 230–235.
