Conservative management feasible for adnexal masses

(HealthDay)—The risk for malignancy and acute complications is low for patients with an adnexal mass with benign ultrasound morphology who are managed conservatively, according to a study published online Feb. 5 in the The Lancet Oncology.

Wouter Froyman, M.D., from the Leuven Cancer Institute in Belgium, and colleagues conducted a two-year interim analysis of patients from an international cohort study (International Ovarian Tumor Analysis Phase 5) who were selected for conservative management of an adnexal mass judged to be benign on ultrasound. Conservative management included ultrasound and clinical follow-up at three- and six-month intervals and then every 12 months.

Twenty-six percent of 2,587 patients with follow-up data had a mass that was already in follow-up at recruitment, and 74 percent (1,919 patients) presented with a new mass at recruitment. The researchers found that patients with new masses were followed for a median of 27 months. Among those with a new mass at recruitment, the cumulative incidence of spontaneous resolution within two years of follow-up was 20.2 percent; the cumulative incidence of finding an invasive malignancy at surgery, a borderline tumor, torsion, and cyst rupture was 0.4, 0.3, 0.4, and 0.2 percent, respectively.

“Such knowledge could be of great value when counselling patients and supports conservative management of adnexal masses that are classified as benign by use of ultrasound,” the authors write.

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