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In human women, oogenesis produces one mature egg cell or ovum for every precursor cell that enters meiosis. This process differs in two unique ways from the equivalent procedure of spermatogenesis in males. First, meiotic divisions during oogenesis are asymmetric, meaning that a large oocyte (containing most of the cytoplasm) and minor polar body are produced as a result of meiosis I, and again following meiosis II. Since only oocytes will go on to form embryos if fertilized, this unequal...
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  1. Home
  3. Reducing Unnecessary Oophorectomies For Benign Ovarian Neoplasms In Pediatric Patients.
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  3. Reducing Unnecessary Oophorectomies For Benign Ovarian Neoplasms In Pediatric Patients.

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Reducing Unnecessary Oophorectomies for Benign Ovarian Neoplasms in Pediatric Patients.

Peter C Minneci1,2, Katherine C Bergus1, Carley Lutz1

  • 1Center for Surgical Outcomes Research, Abigail Wexner Research Institute and Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus.

JAMA
|October 3, 2023

View abstract on PubMed

Summary
This summary is machine-generated.

A new risk stratification algorithm reduced unnecessary oophorectomies in adolescents by identifying benign ovarian masses. This approach aims to prevent lifelong health consequences associated with the removal of healthy ovaries.

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Area of Science:

  • Pediatric surgery
  • Gynecologic oncology
  • Risk assessment

Background:

  • Most ovarian masses in children and adolescents are benign.
  • Oophorectomy for benign masses can lead to lifelong negative health effects.
  • Unnecessary oophorectomies are a concern in pediatric gynecology.

Purpose of the Study:

  • To evaluate a consensus-based preoperative risk stratification algorithm.
  • To assess the algorithm's ability to differentiate benign from malignant ovarian pathology.
  • To reduce the rate of unnecessary oophorectomies in pediatric patients.

Main Methods:

  • A pre/post interventional study was conducted across 11 US children's hospitals.
  • A risk stratification algorithm was implemented for patients aged 6-21 years with ovarian masses.
  • Data were collected over 18 months, with preintervention and intervention phases analyzed.

    • Main Results:

    • The rate of unnecessary oophorectomies decreased from 16.1% preintervention to 8.4% during the intervention.
    • The algorithm demonstrated high sensitivity (91.6%) and specificity (90.0%) for identifying benign lesions.
    • Misclassification of malignant disease treated with ovary-sparing surgery was low (0.7%).

    Conclusions:

    • A preoperative risk stratification algorithm effectively reduced unnecessary oophorectomies in adolescents.
    • This algorithm aids in identifying benign ovarian masses suitable for ovary-sparing surgery.
    • Widespread adoption could prevent long-term health issues related to oophorectomy in young females.