Shared Algorithm Supports Ovary-Sparing Surgery
Research By: Beth Rymeski, DO | Lesley Breech, MD
Post Date: October 3, 2023 | Publish Date: Oct. 3, 2023
Pediatric and Adolescent Gynecology | Top Scientific Achievement
Most ovarian masses found in girls are benign, yet many are managed via oophorectomies that remove entire ovaries. The result of unnecessary removals can have life-long impacts upon a woman’s life.
Previous to this study, the percentage of children receiving ovary-sparing surgery ranged widely between providers (from 18% to 77%). The risks of unnecessary ovary removal include reduced fertility and impaired sexual health, early menopause, potential cognitive impairment and early dementia, osteopenia, and cardiovascular disease.
Now, a study organized by the Midwest Pediatric Surgery Consortium shows that applying a preoperative risk stratification algorithm can reduce the numbers of unneeded oophorectomies. Cincinnati Children’s experts involved in the study included Lesley Breech, MD, Beth Rymeski, DO, and Michael Helmrath, MD.
The study included 519 patients aged 6 to 21 years who received surgery for an ovarian mass at one of 11 participating children’s hospitals between August 2018 and January 2021. The surgical teams conducted a standardized set of evaluations including medical history and physical examination, imaging studies, and serum tumor markers to stratify risk. In a previous single-site study, this algorithm reduced unnecessary oophorectomies from 72% to 4.6% with no missed malignancies. In this larger, multicenter cohort, the percentage of unnecessary oophorectomies decreased from 16.1% to 8.4%.
“In previous studies, pediatric surgeons were found to be more likely than pediatric and adolescent gynecologists to perform unnecessary oophorectomies. These specialty-based differences existed in our preintervention cohort but were minimized after algorithm implementation,” Breech says.
In addition to the Cincinnati Children’s co-authors, this study included experts from Nemours Children’s Hospital–Delaware Valley, Nationwide Children’s Hospital, Children’s Hospital of Wisconsin, St. Louis Children’s Hospital, Norton Children’s Hospital, C. S. Mott Children’s Hospital, Children’s Mercy Kansas City, Ann and Robert H. Lurie Children’s Hospital of Chicago, Riley Hospital for Children, American Family Children’s Hospital, and Comer Children’s Hospital.
Explore the 2024 Research Annual Report
| Original title: | Reducing Unnecessary Oophorectomies for Benign Ovarian Neoplasms in Pediatric Patients |
| Published in: | JAMA |
| Publish date: | Oct. 3, 2023 |
Research By
Latest Posts
About this blog
The Research Horizons blog features news and insights about the latest discoveries and innovations developed by the scientists of Cincinnati Children's. This blog does not provide medical advice, diagnosis, or treatment.
Subscribe to Our Newsletter