Standardizing the surgical management of benign ovarian tumors in children and adolescents: A best practice Delphi consensus statement.
Delphi survey
fertility preservation
ovarian teratoma
ovarian tumor
ovary-sparing operations
pediatric
surveillance
Journal
Pediatric blood & cancer
ISSN: 1545-5017
Titre abrégé: Pediatr Blood Cancer
Pays: United States
ID NLM: 101186624
Informations de publication
Date de publication:
04 2022
04 2022
Historique:
revised:
09
01
2022
received:
11
10
2021
accepted:
10
01
2022
pubmed:
5
2
2022
medline:
6
5
2022
entrez:
4
2
2022
Statut:
ppublish
Résumé
No widely agreed consensus protocols exist for the management of benign ovarian tumors (BOT) in children. This presents a substantial risk for suboptimal management. We aimed to generate multispecialty consensus guidance to standardize surgical management and provide a clear follow-up protocol for children with BOTs. Prospective two-round confidential e-Delphi consensus survey distributed among multispecialty expert panel; concluded by two semistructured videoconferences. Consensus was generated on these core outcome sets: preoperative/intraoperative management; follow-up; adolescent gynecology referral. (1) Children with BOTs should receive the same management as other patients with potentially neoplastic lesions: Preoperative discussion at a pediatric oncology multidisciplinary meeting to risk stratify tumors, and management by health professionals with expertise in ovarian-sparing surgery and laparoscopy. (2) Ovarian-sparing surgery for BOTs should be performed wherever possible to maximize fertility preservation. (3) Ovarian masses detected during emergency laparoscopy/laparotomy should be left in situ wherever feasible and investigated appropriately (imaging/tumor markers) before resection. (4) Follow-up should be undertaken for all patients after BOT resection. Patients should be offered referral to adolescent gynecology to discuss fertility implications. This best practice Delphi consensus statement emphasizes the importance of managing children with BOTs through a well-defined oncological MDT strategy, in order to optimize risk stratification and allow fertility preservation by ovarian-sparing surgery wherever possible.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e29589Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2022 Wiley Periodicals LLC.
Références
Braungart S, Craigie RJ, Losty PD. Controversies in the management of ovarian tumours in prepubertal children - a BAPS and UK CCLG Surgeons Cancer Group national survey. J Pediatr Surg. 2018;53(11):2231-2234.
Childrens' Cancer and Leukaemia Group Germ Cell Tumour Group; Brougham M, Nicholson J, Stoneham S, et al. Interim guideline for the treatment of extracranial germ cell tumours in children and adolescents. Accessed 07, 2020. https://www.cclg.org.uk/write/MediaUploads/Member%20area/Treatment%20guidelines/614_Extracranial_GCT_Guidance_updated_June_2018.pdf. CCLG 2018
Ritchie J, O'Mahony F, Garden A, on behalf of British Society for Paediatric & Adolescent Gynaecology. Guideline for the management of ovarian cysts in children and adolescents. Accessed 07, 2020. https://britspag.org/wp-content/uploads/2019/11/Ovarian-cyst-management-in-PAG-guideline-revised.pdf. BritSPAG Dec 2018.
Ovarian Masses in Premenopausal Women, Management of Suspected (Green-top Guideline No. 62). Accessed 07, 2020. https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg62/Royal College of Obstetrics and Gynaecology Dec 2011.
Braungart S, Craigie RJ, Farrelly P, Losty PD, CCLG Surgeons Collaborators. Ovarian tumors in children: how common are lesion recurrence and metachronous disease? A UK CCLG Surgeons Cancer Group nationwide study. J Pediatr Surg. 2020;55(10):2026-2029.
Braungart S, Craigie RJ, Farrelly P, Losty PD, CCLG Surgeons Collaborators. Operative management of pediatric ovarian tumors and the challenge of fertility-preservation: results from the UK CCLG Surgeons Cancer Group nationwide study. J Pediatr Surg. 2020;55(11):2425-2429.
Terenziani M, D'Angelo P, Inserra A, Boldrini R, Bisogno G, Babbo GL, et al. Mature and immature teratoma: a report from the second Italian pediatric study. Pediatr Blood Cancer. 2015;62(7):1202-1208.
Chabaud-Williamson M, Netchine I, Fasola S, Larroquet M, Lenoir M, Patte C, et al. Ovarian-sparing surgery for ovarian teratoma in children. Pediatr Blood Cancer. 2011;57:429-434.
Taskinen S, Urtane A, Fagerholm R. Metachronous benign ovarian tumors are not uncommon in children. J Pediatr Surg. 2014;49:543-545.
Yasui T, Hayashi K, Mizunuma H, Kubota T, Aso T, Matsumura Y, et al. Factors associated with premature ovarian failure, early menopause and earlier onset of menopause in Japanese women. Maturitas. 2012;72:249-255.
Rosendahl M, Simonsen MK, Kjer JJ. The influence of unilateral oophorectomy on the age of menopause. Climacteric. 2017;20(6):540-544.
Rocca WA, Bower JH, Maraganore DM, Ahlskog JE, Grossardt BR, de Andrade M, et al. Increased risk of cognitive impairment or dementia in women who underwent oophorectomy before menopause. Neurology. 2007;69:1074-1083.
Williamson PR, Altman DG, Bagley H, Barnes KL, Blazeby JM, Brookes ST, et al. The COMET handbook: version 1.0. Trials. 2017;18:280.
Rowe G, Wright G. The Delphi technique as a forecasting tool: issues and analysis. Int J Forecast. 1999;15:353-375.
Jones J, Hunter D. Consensus methods for medical and health services research. BMJ. 1995;311:376-380.
LimeSurvey. Accessed 10, 2020. https://www.limesurvey.org
Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ. 2004;328(7454):1490.
Schmitt J, Langan S, Stamm T, Williams HC. Harmonizing outcome measurements in eczema (HOME) Delphi panel. Core outcome domains for controlled trials and clinical recordkeeping in eczema: international multiperspective Delphi consensus process. J Invest Dermatol. 2011;131(3):623-630.
Anthony EY, Caserta MP, Singh J, Chen MY. Adnexal masses in female pediatric patients. AJR Am J Roentgenol. 2012;198(5):W426-31.
Griffin N, Grant LA, Sala E. Adnexal masses: characterization and imaging strategies. Semin Ultrasound CT MR. 2010;31(5):330-346.
Janssen CL, Littooij AS, Fiocco M, Huige JCB, de Krijger RR, Hulsker CCC, et al. The diagnostic value of magnetic resonance imaging in differentiating benign and malignant pediatric ovarian tumors. Pediatr Radiol. 2021;51(3):427-434.
van Nimwegen LWE, Mavinkurve-Groothuis AMC, de Krijger RR, Hulsker CCC, Goverde AJ, et al. MR imaging in discriminating between benign and malignant paediatric ovarian masses: a systematic review. Eur Radiol. 2020;30(2):1166-1181.
Lawrence AE, Fallat ME, Hewitt G, Hertweck P, Onwuka A, Afrazi A, et al. Midwest pediatric surgery consortium. understanding the value of tumor markers in pediatric ovarian neoplasms. J Pediatr Surg. 2020;55(1):122-125.
Raivio T, Dunkel L. Inhibins in childhood and puberty. Best Pract Res Clin Endocrinol Metab. 2002;16(1):43-52.
Renaud EJ, Sømme S, Islam S, Cameron DB, Gates RL, Williams RF, et al. Ovarian masses in the child and adolescent: an American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee systematic review. J Pediatr Surg. 2019;54(3):369-377.
Oltmann SC, Garcia N, Barber R, Huang R, Hicks B, Fischer A. Can we preoperatively risk stratify ovarian masses for malignancy?. J Pediatr Surg. 2010;45(1):130-134.
van Heerden J, Tjalma WA. The multidisciplinary approach to ovarian tumours in children and adolescents. Eur J Obstet Gynecol Reprod Biol. 2019;243:103-110.
Dasgupta R, Renaud E, Goldin AB, Baird R, Cameron DB, Arnold MA, et al. Ovarian torsion in pediatric and adolescent patients: a systematic review. J Pediatr Surg. 2018;53(7):1387-1391.
Eisenberg N, Volodarsky-Perel A, Brochu I, Tremblay C, Gorak E, Hudon E, et al. Short- and Long-term complications of intraoperative benign ovarian cyst spillage: a systematic review and meta-analysis. J Minim Invasive Gynecol. 2021;28(5):957-970.
Lawrence AE, Minneci PC, Deans KJ. Ovary-sparing surgery for benign pediatric ovarian masses. Curr Opin Pediatr;31(3):386-390.
Gonzalez DO, Minneci PC, Deans KJ. Management of benign ovarian lesions in girls: a trend toward fewer oophorectomies. Curr Opin Obstet Gynecol. 2017;29(5):289-294. Oct.
Abbas PI, Dietrich JE, Francis JA, Brandt ML, Cass DL, Lopez ME. Ovarian-sparing surgery in pediatric benign ovarian tumors. J Pediatr Adolesc Gynecol. 2016;29(5):506-510.
Papic JC, Finnell SM, Slaven JE, Billmire DF, Rescorla FJ, Leys CM. Predictors of ovarian malignancy in children: overcoming clinical barriers of ovarian preservation. J Pediatr Surg. 2014;49(1):144-147. discussion 147-8.
Nezhat CR, Kalyoncu S, Nezhat CH, Johnson E, Berlanda N, Nezhat F. Laparoscopic management of ovarian dermoid cysts: ten years' experience. JSLS. 1999;3(3):179-184.
Dural O, Yasa C, Bastu E, Ugurlucan FG, Yilmaz G, Yuksel B, et al. Laparoscopic outcomes of adnexal surgery in older children and adolescents. J Pediatr Adolesc Gynecol. 2017;30(1):128-131.
Braungart S, Charlotte S. V: recurrence and metachronous disease in children with benign ovarian tumours - a systematic review of the literature. Eur J Pediatr Surg. 2022 Jan 11. doi: 10.1055/s-0041-1740997.
Fanchin R, Schonäuer LM, Righini C, Guibourdenche J, Frydman R, Taieb J. Serum anti-Mullerian hormone is more strongly related to ovarian follicular status than serum inhibin B, estradiol, FSH and LH on day 3. Hum Reprod. 2003;18(2):323-327.
Bhide P, Pundir J, Homburg R, Acharya G. Biomarkers of ovarian reserve in childhood and adolescence: a systematic review. Acta Obstet Gynecol Scand. 2019;98(5):563-572.
Bjelland EK, Wilkosz P, Tanbo TG, Eskild A. Is unilateral oophorectomy associated with age at menopause? A population study (the HUNT2 Survey). Hum Reprod. 2014;29(4):835-841.
Løkkegaard E, Jovanovic Z, Heitmann BL, Keiding N, Ottesen B, Pedersen AT. The association between early menopause and risk of ischaemic heart disease: influence of hormone therapy. Maturitas. 2006;53:226-233.
Zhu D, Chung HF, Dobson AJ, et al. Age at natural menopause and risk of incident cardiovascular disease: a pooled analysis of individual patient data. Lancet Public Health. 2019;4(11):e553-e564.
Parker WH, Broder MS, Chang E, et al. Ovarian conservation at the time of hysterectomy and long-term health outcomes in the nurses' health study. Obstet Gynecol. 2009;113(5):1027-1037.