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Retrospective cohort study of surgical staging for ovarian low malignant potential tumors.

Wingo SN, Knowles LM, Carrick KS, Miller DS, Schorge JO

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9032, USA.

OBJECTIVE: The purpose of this study was to determine the benefit of surgically staging ovarian low malignant potential tumors. STUDY DESIGN: This was a retrospective cohort study of all ovarian low malignant potential tumors that were diagnosed by frozen section or final pathologic review from 2003 to 2005. RESULTS: Twenty-two of 32 patients (69%) were staged surgically. Sixteen low malignant potential tumors were stage I by final pathologic review, and 4 tumors were upstaged to stage II-III disease. Two other patients had early invasive ovarian carcinoma, despite a frozen section that suggested low malignant potential; 1 patient received adjuvant chemotherapy. The tumors of 10 women (31%) were unstaged. Frozen section suspicion of low malignant potential (P = .003) and surgery by a gynecologic oncologist (P < .001) correlated with staging. Preoperative CA-125, intraoperative blood loss, and postoperative hospitalization were increased in patients with staged disease (each P < .05). Two women who underwent fertility-sparing surgery experienced a recurrence in the contralateral ovary. CONCLUSION: Surgical staging of ovarian low malignant potential tumors has limited value for most patients, unless invasive carcinoma is diagnosed by final pathologic review.

Published 1 May 2006 in Am J Obstet Gynecol, 194(5): e20-2.
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