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Management of pediatric benign ovarian tumors in England and Egypt: A comparative study
Ahmed Elgendy1, Bhanumathi Lakshminarayanan2, Ahmed Elrouby3
1Surgical Oncology Unit, Department of Surgery, Tanta University, Tanta, Egypt.
Insights
Pediatric benign ovarian tumor management showed no significant differences in surgical approach or outcomes between England and Egypt. However, age at diagnosis, incidental findings, and imaging techniques varied between the two regions.
Area of Science:
- Pediatric Surgery
- Gynecologic Oncology
- Comparative Healthcare Management
Background:
- Benign ovarian tumors are common in pediatric patients.
- Management strategies can vary significantly across different healthcare systems.
- Understanding these variations is crucial for optimizing patient care.
Purpose of the Study:
- To compare the management of pediatric benign ovarian tumors between an English center and three Egyptian institutions.
- To identify differences in diagnostic approaches, surgical interventions, and patient outcomes.
Main Methods:
- Retrospective review of pediatric patients with benign ovarian tumors from January 2014 to January 2019.
- Utilized a standardized dataset for comparative analysis between English and Egyptian cohorts.
- Included 89 patients: 54 from England and 35 from Egypt.
Main Results:
- Median age at diagnosis differed significantly (England: 13 years vs. Egypt: 7 years).
- Mature teratomas were the most common pathology in both regions.
- Imaging modalities and rates of incidental diagnosis varied, with England utilizing more MRI and CT, and having incidental diagnoses, while Egypt relied more on Ultrasound (USS).
- Minimally invasive surgery (MIS) and ovarian-sparing surgery (OSS) rates showed no significant difference, though OSS was frequently performed via MIS.
- Emergency presentations were more likely to result in open oophorectomy in both countries.
Conclusions:
- Surgical management, tumor pathology, and recurrence rates for pediatric benign ovarian tumors were comparable between England and Egypt.
- Significant differences were observed in patient age at diagnosis, the rate of incidental diagnosis, and the utilization of diagnostic imaging modalities.
- Minimally invasive surgery was associated with ovarian preservation, while emergency presentations often led to open oophorectomy.
Aim Of The Study:
We aimed to compare the management of pediatric benign ovarian tumors between an English center and three Egyptian institutions.
Materials And Methods:
This was a retrospective review of all children presenting with benign ovarian tumors between January 2014 and January 2019. A standardized dataset was used to compare between both sides.
Results:
Eighty-nine patients were included (54 English and 35 Egyptians). Median age at diagnosis in England was 13 years (2-16y), while in Egypt it was 7 years (9m-16y) with P =0.001. Mature teratomas or dermoid cysts were the most common findings in England and Egypt; 75.9% and 82.8% of cases, respectively. The presentation with an acute abdomen represented 27.8% of English and 28.6% of Egyptian patients. Incidentally diagnosed lesions constituted 15% of English patients, whereas none of the Egyptian cases were discovered incidentally. There were variations in diagnostic imaging; England: Ultrasound (USS) (54), magnetic resonance imaging (MRI) (37), and computed tomography (CT) (only one)-Egypt: USS (35), CT (17), and MRI (only one). Minimally invasive surgery (MIS) was performed in 15% of English and 23% of Egyptian patients (P = 0.334). Ovarian-sparing surgery (OSS) was performed in: England 35%, Egypt 37%; P = 0.851. OSS was performed using MIS in 87.5% (7/8) of English patients and 100% (8/8) of Egyptians. Patients presented as emergencies generally had open oophorectomies: England; 86.7% open and 80% oophorectomy-Egypt; 100% open and 90% oophorectomy. Recurrences or metachronous disease occurred in 5.6% of English and 5.7% of Egyptian patients.
Conclusions:
There were no significant differences regarding surgical management, tumor pathology, and recurrence or metachronous disease. However, age, incidental diagnosis, and imaging modalities showed notable differences. MIS was correlated with ovarian preservation, whereas emergency surgery generally resulted in open oophorectomy.
