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


Authors: Juretzka, M. M.; Crawford, C. L.; Lee, C.; Wilton, A.; Schuman, S.; Chi, D. S.; Sonoda, Y.; Barakat, R. R.; Abu-Rustum, N. R.
Article Title: Laparoscopic findings during adnexal surgery in women with a history of nongynecologic malignancy
Abstract: 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. © 2005 Elsevier Inc. All rights reserved.
Keywords: adult; controlled study; aged; aged, 80 and over; middle aged; leukemia; retrospective studies; major clinical study; anamnesis; cancer diagnosis; laparoscopy; laparotomy; neoplasms; colorectal cancer; ovarian cancer; multiple myeloma; ovary cancer; breast cancer; tumor volume; lung cancer; retrospective study; urogenital tract cancer; digestive system cancer; body mass; statistical significance; head and neck cancer; lymphoma; ca 125 antigen; abdominal surgery; time series analysis; radiodiagnosis; upper gastrointestinal tract; tumor diagnosis; pelvis surgery; adnexa disease; adnexa uteri; adnexal mass; nongynecologic malignancy
Journal Title: Gynecologic Oncology
Volume: 101
Issue: 2
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2006-05-01
Start Page: 327
End Page: 330
Language: English
DOI: 10.1016/j.ygyno.2005.10.025
PUBMED: 16360202
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 3" - "Export Date: 4 June 2012" - "CODEN: GYNOA" - "Source: Scopus"
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MSK Authors
  1. Andrew Wilton
    27 Wilton
  2. Richard R Barakat
    629 Barakat
  3. Dennis S Chi
    604 Chi
  4. Yukio Sonoda
    375 Sonoda
  5. Christina J Lee
    1 Lee