Performance of laparoscopy in identifying malignant ovarian cysts.

Authors :: Bensaid C
Le Frère Belda MA
Metzger U
Larousserie F
Clément D
Chatellier G
Lécuru F
Source :: Surgical endoscopy [Surg Endosc] 2006 Sep; Vol. 20 (9), pp. 1410-4. Date of Electronic Publication: 2006 Jun 26.
Publication Year :: 2006
Abstract: Background: Peroperative identification of malignancy is crucial to management planning for ovarian cysts. The aim of this study was to evaluate the performance of laparoscopy in identifying malignant ovarian cysts.<br />Methods: Patients undergoing laparoscopy for ovarian cysts from 1998 to 2001 were enrolled prospectively. Physical findings, Doppler ultrasonography, and serum CA 125 served to compute two risk-of-malignancy indexes (RMI-1 and RMI-2), and laparoscopy findings served to categorize lesions as benign, possibly malignant, or malignant. Frozen sections were examined as needed. Final histology was the reference.<br />Results: Of 313 patients, 294 had benign cysts, six borderline lesions, and 13 malignancies. Sensitivity and specificity were respectively 84 and 93% for RMI-1, 92 and 80% for RMI-2, 100 and 99% for laparoscopy, 91 and 100% for frozen sections, and 100 and 100% for laparoscopy plus frozen sections, which had 100% negative predictive value. Six (1.8%) adverse events occurred.<br />Conclusions: Laparoscopy reliably identifies ovarian cancer and borderline disease. Morbidity is low compared to oncologic surgery.