Conservative Management Approach to Benign Ovarian Cysts and Risk of Complications
Posted: Wednesday, February 27, 2019
Wouter Froyman, MD, of the Leuven Cancer Institute, Belgium, and international colleagues published the results of an 2-year analysis of IOTA5, an ongoing multicenter, prospective, cohort study, in The Lancet Oncology, supporting conservative management of adnexal masses classified as benign. The researchers aimed to assess the risks of complications and malignancy associated with choosing close monitoring using ultrasound versus surgical removal of these ovarian cysts. They also addressed the current fears of misdiagnosis, or transition of cysts into cancerous tissue, that leads many patients to elect surgery as well as the increasing number of patients at risk of surgical complications.
Of the 1,919 women included in this interim analysis, 20.2 % had cysts that underwent spontaneous resolution within 2 years. The risks included finding invasive malignancy at surgery (0.4 %), cystic torsion (0.4 %), and cyst rupture (0.2 %). These interim results indicate the value of conservative management and the benefits to patients of further discussion of comparative risks when determining treatment for benign ovarian cysts.
Lead researcher from the Imperial College of London (ICP), Professor Tom Bourne commented in a news story from ICP: “Our results may lead to a paradigm shift resulting in less surgery for noncancerous ovarian cysts—on condition that trained ultrasound examiners reliably exclude cancer.”
Disclosure: The study authors’ disclosure information may be found at thelancet.com.