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Triage for surgical management of ovarian tumors in asymptomatic women: assessment of an ultrasound‐based scoring system
Author(s) -
Alcázar J. L.,
Royo P.,
Jurado M.,
Mínguez J. Á.,
GarcíaManero M.,
Laparte C.,
Galván R.,
LópezGarcía G.
Publication year - 2008
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.5401
Subject(s) - medicine , triage , asymptomatic , ultrasound , scoring system , radiology , general surgery , gynecology , surgery , medical emergency
Objectives To prospectively evaluate an ultrasound‐based scoring system as a method for triaging asymptomatic women presenting with an adnexal mass for surgical treatment. Methods Two hundred and four adnexal masses in 189 asymptomatic women undergoing elective surgical treatment at our institution were included in this prospective study. Patients were evaluated by transvaginal power Doppler ultrasound imaging before surgery. Patients were classified as low risk or high risk for malignancy according to an ultrasound‐based scoring system. Women with a low risk for malignancy were scheduled for laparoscopy and patients with a high risk for malignancy were scheduled for laparotomy. However, patients classified as low risk by the ultrasound scoring system, but with a tumor size ≥ 10 cm or clinical suspicion of pelvic adhesions, were instead considered to be at intermediate risk and were scheduled for laparotomy. Some patients classified as high risk were scheduled for an operative laparoscopy by an expert in gynecological oncology. Results One hundred and thirty‐four (65.7%) masses were considered to be low risk and were treated by a laparoscopically guided procedure. All these tumors were benign. Forty‐seven (23%) masses were classified as high risk, of which 39 tumors were malignant and eight benign. Twenty‐three (11.3%) tumors were considered to be intermediate risk and were scheduled for primary laparotomy. In this group, 21 (91.3%) tumors proved to be benign and two (8.7%) were malignant. Conclusions Ultrasound‐based triage of asymptomatic women diagnosed with a persistent adnexal mass is effective for selecting the surgical approach. Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd.