The Presence of Ascites and Irregular Tumor Surface as Strong Predictors for Ovarian Malignancy

Dodi Suardi; Abi Ryamafi Bazar; Gatot Nyarumenteng Adhipurnawan Winarno; Yudi Mulyana Hidayat; Ali Budi Harsono; Siti Salima; Dino Rinaldy; Basuki  Hidayat; Raden Tina Dewi Judistiani; Budi Setiabudiawan

doi:10.3889/oamjms.2023.9134

Authors

Dodi Suardi Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin Hospital Bandung, West Java, Indonesia
Abi Ryamafi Bazar https://orcid.org/0000-0002-4272-9727
Gatot Nyarumenteng Adhipurnawan Winarno Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin Hospital Bandung, West Java, Indonesia
Yudi Mulyana Hidayat Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin Hospital Bandung, West Java, Indonesia
Ali Budi Harsono Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin Hospital Bandung, West Java, Indonesia
Siti Salima Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin Hospital Bandung, West Java, Indonesia
Dino Rinaldy Department of Obstetrics and Gynecology, Faculty of Medicine, Lampung University, Dr. Abdul Moeloek General Hospital, Lampung, Indonesia
Basuki Hidayat Department of Nuclear Medicine and Molecular Theranostic, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin Hospital Bandung, West Java, Indonesia https://orcid.org/0000-0001-6168-976X
Raden Tina Dewi Judistiani Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin Hospital Bandung, West Java, Indonesia
Budi Setiabudiawan Department of Pediatric, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin Hospital Bandung, West Java, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2023.9134

Keywords:

Ovarian cancer, Operator’s assesment, Intraoperative frozen section, Tumor gross appearance, Benign tumor, Non-benign tumor

Abstract

BACKGROUND: Ovarian cancer is the most dangerous gynecologic cancer and one of the top five causes of cancer death in women. One of the intraoperative strategies to diagnose and manage women with ovarian cancer is by doing intraoperative frozen section examination during surgery, but not all hospitals in Indonesia have this facilities, thus makes it difficult to achieve intraoperative diagnosis, which lead to substandard management of patients with ovarian cancer.

AIM: The purpose of this study is to investigate if one can determine whether an ovarian tumor is benign or not based on the gross appearance of the tumor.

METHODS: This study is a comparative, analytic, and cross-sectional study to compare the results of operator’s assessment with the results of intraoperative frozen section examination in determining malignancy during surgery. After the tumor was removed, it was assessed by operator based on the gross appearance of the tumor whether the tumor was benign or not, then the tumor underwent frozen section examination, and based on the frozen section examination results, the patient was treated accordingly. Both of the results then compared to the histopathologic (paraffin block) results, as the gold standard of pathologic diagnosis.

RESULTS: This study shows that variables ascites, tumor seedings, tumor surface, tumor consistency, tumor lobes, and lymph node enlargement are statistically significant (p < 0.05). The combinations of highly significant variables (p < 0.01) show that a combination of ascites and irregular tumor surface give the suggestions that an ovarian is highly likely a non-benign tumor.

CONCLUSION: In the absence of intraoperative frozen section examination in a hospital, operator’s assessment based on gross appearance of the tumor can be used as a substitute for intraoperative frozen section examination to determine the malignancy of an ovarian tumor during surgery.

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