Introduction/Background To evaluate the effectiveness of closed suction technique (CST) for surgical treatment of huge ovarian cyst in terms of oncologic safety.
Methodology A total of 211 women who underwent surgery including at least unilateral salpingo-oophorectomy for huge ovarian cyst ≥10 cm were retrospectively reviewed (figure 1). Information about tumor characteristics, surgical approach, gross tumor spillage during surgery (no rupture, gross rupture, and CST), pathology, adjuvant chemotherapy and tumor recurrence was collected.
Results Tumor size was 19.0±6.9 cm (mean±SD). Of 211, 129 (61.1%), 34 (16.1%), and 48 (22.8%) were benign, borderline, and cancer, respectively. In tables 1 and 2, laparoscopy was used in 132 (62.6%) and open surgery was used in 79 (37.4%). In laparoscopic surgery, vast majority of cysts (73/79, 92.4%) were ruptured and 2.7% (2/73) of the ruptured cysts was cancer. The two received adjuvant chemotherapy, but one had recurrence. In open surgery, 39.4% (52/132) were ruptured and 42.3% (22/52) of them was malignant. CST was used in 34.1% (45/132). Among 46 who were diagnosed with malignancy by open surgery, 15 (34.1%) belonged to stage IC1 because of tumor rupture during surgery. Median follow-up of the 46 patients was 43 months (0–124 months). There were 4 (8.7%) cancer recurrences: 3 in gross rupture group despite adjuvant chemotherapy and 1 in CST group without adjuvant chemotherapy. Recurrence rate was similar between gross rupture and CST groups (13.6%, 3/22 vs. 11.1%, 1/9; p>0.999) (figure 1). In 12 women who did not receive chemotherapy after open surgery irrespective of stage, recurrent rate was not different between 3 groups. In no rupture group, there was no chemotherapy and no recurrence.
Conclusion Huge ovarian cyst ≥10 cm has high likelihood of tumor rupture during surgery even in open surgery. Gross tumor rupture increases recurrence despite adjuvant chemotherapy. CST does not seem to be effective in preventing tumor recurrence.
Disclosure Nothing to disclose.
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