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Eur J Pediatr Surg 2022; 32(01): 098-104
DOI: 10.1055/s-0041-1740997
Original Article

Recurrence and Metachronous Disease in Children with Benign Ovarian Tumors: A Systematic Review of the Literature

Sarah Braungart 
1   Department of Paediatric Surgery, Royal Manchester Children's Hospital, Manchester, United Kingdom of Great Britain and Northern Ireland
,
Charlotte Victoria Smith
2   North West of England School of Foundation Training and Physician Associates - FY2, St Helen's and Knowsley, United Kingdom of Great Britain and Northern Ireland
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Abstract

Aim The majority of ovarian tumors in children are benign, with good prognosis following complete resection. Little is published on the incidence of tumor recurrence and metachronous disease, and follow-up management of children with benign ovarian tumors (BOTs) remains a matter of debate. This systematic review aimed to evaluate the incidence and timing of recurrence and metachronous disease in children with BOTs in pediatric literature.

Methods Comprehensive literature searches of the English literature (PubMed, OVID, EMBASE databases) from inception to present according to the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. Outcomes for tumor recurrence and metachronous disease were synthesized.

Results Nineteen studies comprising 1,069 patients with BOTs were included in the analysis. All studies were retrospective cohort studies of children less than 18 years old. A total of 56 events of recurrence or metachronous disease were reported in these patients. The overall risk of recurrence/metachronous event occurrence was 5.2%/2.9%. Seventy-five percent of events occurred within the first 4 years following resection.

Conclusion Although the studies identified are few and heterogeneous, they demonstrate a significant risk of tumor recurrence and metachronous disease for children following resection of a BOT.

Especially following total unilateral oophorectomy, these children are at risk of losing the contralateral ovary in case of metachronous disease.

Immediate discharge from follow-up, therefore, does not appear safe. The majority of events occurred within the first 4 years following resection. Follow-up for children following resection of a BOT should, therefore, be continued for a minimum of 4 years following surgery. Larger, long-term prospective studies are required to more accurately determine the true incidence and long-term outcomes for children and adolescents with these tumors.

Keywords

metachronous disease - pediatrics - ovarian teratoma - ovarian tumor - follow-up


Publication History

Received: 09 July 2021

Accepted: 18 November 2021

Article published online:
11 January 2022

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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