Investigation of the Predictive Factors of Recurrent Ovarian Mucinous Cystadenoma

Abstract

OBJECTIVE: Rapid growth patterns and recurrence with variable rates have been reported in the liter- ature, making mucinous cystadenomas different from other ovarian benign neoplasms. The study aimed to predict and prevent recurrence based on the obtained results. STUDY DESIGN: In this case-control study among the 2,341 patients who underwent surgery for ovar- ian cysts, 221 met the inclusion criteria. The 221 patients diagnosed with mucinous cystadenoma were categorized into two groups: 14 patients (6.3%) with recurrence and 207 patients (93.7%) without re- currence. Patients in these groups were compared in terms of demographic characteristics, ovarian cyst size, operative technique, type of surgery (oophorectomy or cystectomy), Ca19-9, CA125, and CEA val- ues of the patients, and duration of postoperative follow-up. RESULTS: The mean age was statistically lower in the group with recurrence (27±5 vs 44±14; p<0.001). The follow-up period of recurrent cases was significantly longer (6.8 ± 3.5 vs 4.9 ± 2.2 years; p=0.045). The recurrence rate was significantly higher in patients who underwent cystectomy (p<0.001; odds ratio: 22.8). When all patients were examined, cystectomy was preferred in younger patients [31 (18-65) vs 48 (18-81); p<0.001]. According to regression analysis, cystectomy alone is an independent risk factor (p=0.041). CONCLUSION: Unlike conventional ovarian cystadenomas, mucinous cystadenomas should be fol- lowed up owing to the possibility of recurrence, especially when detected at an early age. Since cys- tectomy is the only independent risk factor, oophorectomy should be the primary treatment for patients >40 years of age who have no desire for childbearing.