Features of Diagnostics and Surgical Treatment of Ovarian Tumors in Children

Abstract

The purpose of current work was to assess prognostically significant laboratory parameters in patients with ovarian tumors, as well as to determine optimal types of surgical treatment. From 1994 to 2020, 40 patients with various ovarian tumors were under our observation. They were divided into three groups: benign tumors (n = 11, 27.5 %), borderline tumors (n = 9, 22.5 %) and malignant tumors (n = 20, 50 %). The most informative laboratory parameters were serum tumor markers, including alpha-fetoprotein (AFP), β-human chorionic gonadotropin (B‑HCG), CA‑125 and lactate dehydrogenase (LDH). In the patients with benign ovarian neoplasms the levels of AFP, B‑HCG, CA‑125 did not exceed normal values adjusted to age, while in 27 % of cases LDH elevation was detected. In the group of borderline ovarian tumors the levels of AFP and B‑HCG were within the normal range in all patients, CA‑125 was elevated in 22 % of cases. In the malignant tumor group AFP exceeded the age norm in 60 % of cases, B‑HCG — in 15 %, CA‑125 — in 35 %, LDH — in 60 % of cases. Totally, in this group elevated levels of tumor markers were in 90 % cases. Surgical treatment was performed in 39 patients. In the group of patients with benign ovarian tumors, the proportion of laparoscopic operations was 36 %; adnexectomy prevailed in this group (73 %). In three cases, ovarian-sparing operations were performed. In patients with malignant ovarian tumors radical surgical interventions were performed in 90 % of cases. In these cases, laparotomy and adnexectomy with resection of the omentum were primary performed in 50 % of cases, while in 40 % of cases, radical intervention was achieved only as a result of repeated operation. 10‑year overall survival (OS) in the group of patients with primary radical surgery was 100 %. Although in the group with repeated surgical interventions, the 10‑year OS was 52.5 % only (p < 0.001). Thus, the isolated or combined elevation of tumor markers i. e. AFP, B‑HCG, CA‑125, LDH indicates the high probability of the malignant ovarian tumor. The prognosis of patients with ovarian tumors depends on the timeliness and volume of primary surgical treatment.