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Surgical management of ovarian tumors without the support of intraoperative pathology readings in Bhaktapur Cancer Hospital

Intraoperative frozen section plays an important role in surgical management of ovarian masses. Many hospitals in low- and middle-income countries lack this intraoperative pathologic guidance. In this retrospective analysis, we assessed the management of 62 patients who underwent surgical treatment...

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Autores principales: Marinone, Michelle, Shrestha, Eliza, Thapa, Anita, Tuladar, Ruhee, Wakefield, Dorothy B., Chuang, Linus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7300083/
https://www.ncbi.nlm.nih.gov/pubmed/32577489
http://dx.doi.org/10.1016/j.gore.2020.100589
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author Marinone, Michelle
Shrestha, Eliza
Thapa, Anita
Tuladar, Ruhee
Wakefield, Dorothy B.
Chuang, Linus
author_facet Marinone, Michelle
Shrestha, Eliza
Thapa, Anita
Tuladar, Ruhee
Wakefield, Dorothy B.
Chuang, Linus
author_sort Marinone, Michelle
collection PubMed
description Intraoperative frozen section plays an important role in surgical management of ovarian masses. Many hospitals in low- and middle-income countries lack this intraoperative pathologic guidance. In this retrospective analysis, we assessed the management of 62 patients who underwent surgical treatment for ovarian masses at Bhaktapur Cancer Hospital in Nepal in light of the final histopathology results. Final histopathology found that 64.5% of the ovarian masses were malignant, 1.0% were borderline, and 30.6% were benign. 55 of the 62 total cases were considered “clinically suspicious” and 52 of the 62 cases underwent hysterectomy and staging procedures in addition to oophorectomy. There was no significant difference in the surgical management or in the postoperative complications when comparing benign, borderline, and malignant masses. Without the support of intraoperative frozen section, benign and malignant masses were treated the same way. The majority of benign cases were overtreated and were exposed to additional risks of postoperative complications. Several malignant cases were undertreated and required additional surgery to appropriately treat and stage malignant ovarian masses. Improved pathology support in Bhaktapur Cancer Hospital would result in better patient outcomes, fewer complications, and avoidance of additional staging surgeries.
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spelling pubmed-73000832020-06-22 Surgical management of ovarian tumors without the support of intraoperative pathology readings in Bhaktapur Cancer Hospital Marinone, Michelle Shrestha, Eliza Thapa, Anita Tuladar, Ruhee Wakefield, Dorothy B. Chuang, Linus Gynecol Oncol Rep Special Section on Global Gynecologic Oncology; Edited by Linus Chuang and Thomas Randall Intraoperative frozen section plays an important role in surgical management of ovarian masses. Many hospitals in low- and middle-income countries lack this intraoperative pathologic guidance. In this retrospective analysis, we assessed the management of 62 patients who underwent surgical treatment for ovarian masses at Bhaktapur Cancer Hospital in Nepal in light of the final histopathology results. Final histopathology found that 64.5% of the ovarian masses were malignant, 1.0% were borderline, and 30.6% were benign. 55 of the 62 total cases were considered “clinically suspicious” and 52 of the 62 cases underwent hysterectomy and staging procedures in addition to oophorectomy. There was no significant difference in the surgical management or in the postoperative complications when comparing benign, borderline, and malignant masses. Without the support of intraoperative frozen section, benign and malignant masses were treated the same way. The majority of benign cases were overtreated and were exposed to additional risks of postoperative complications. Several malignant cases were undertreated and required additional surgery to appropriately treat and stage malignant ovarian masses. Improved pathology support in Bhaktapur Cancer Hospital would result in better patient outcomes, fewer complications, and avoidance of additional staging surgeries. Elsevier 2020-05-26 /pmc/articles/PMC7300083/ /pubmed/32577489 http://dx.doi.org/10.1016/j.gore.2020.100589 Text en © 2020 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Special Section on Global Gynecologic Oncology; Edited by Linus Chuang and Thomas Randall
Marinone, Michelle
Shrestha, Eliza
Thapa, Anita
Tuladar, Ruhee
Wakefield, Dorothy B.
Chuang, Linus
Surgical management of ovarian tumors without the support of intraoperative pathology readings in Bhaktapur Cancer Hospital
title Surgical management of ovarian tumors without the support of intraoperative pathology readings in Bhaktapur Cancer Hospital
title_full Surgical management of ovarian tumors without the support of intraoperative pathology readings in Bhaktapur Cancer Hospital
title_fullStr Surgical management of ovarian tumors without the support of intraoperative pathology readings in Bhaktapur Cancer Hospital
title_full_unstemmed Surgical management of ovarian tumors without the support of intraoperative pathology readings in Bhaktapur Cancer Hospital
title_short Surgical management of ovarian tumors without the support of intraoperative pathology readings in Bhaktapur Cancer Hospital
title_sort surgical management of ovarian tumors without the support of intraoperative pathology readings in bhaktapur cancer hospital
topic Special Section on Global Gynecologic Oncology; Edited by Linus Chuang and Thomas Randall
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7300083/
https://www.ncbi.nlm.nih.gov/pubmed/32577489
http://dx.doi.org/10.1016/j.gore.2020.100589
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