FREQUENCY OF POSTSURGICAL OUTCOME AMONG PATIENTS PRESENTING WITH OVARIAN MASS AT TERTIARY CARE HOSPITAL SUKKUR

Abstract

Ovarian tumors are a spectrum of diseases with a wide range of pathological characteristics. Because of their deep pelvic location, neoplastic changes frequently grow unnoticed and are detected at a late stage. Socioeconomic factors, absence of a comprehensive national cancer registry and restricted screening protocols in regions around the globe contribute to the diagnostic difficulty, and close post-surgical histopathological analysis is critical for proper diagnosis and management allocation in Pakistan. To find the frequency of post-surgical histopathological findings of patients who presented with ovarian mass at a tertiary care hospital in Sukkur, Pakistan. It is a facility based cross sectional study which was carried out for a period of 6 months at the Department of Gynecology and Obstetrics at Ghulam Mohammad Mahar Medical College Hospital, Sukkur. A total of 153 adnexal mass patients who presented with clinically or radiologically confirmed adnexal masses were enrolled, using non-probability consecutive sampling, in the age group between 20 and 45 years. Tissues were subsequently fixed, processed and stained with hematoxylin and eosin (H&E) for detailed microscopic analysis by senior histopathologists. Data were analyzed using IBM SPSS software version 27.0, cross-tabulations were done by the Pearson Chi-Square test at p < 0.05. The mean age of the cohort was 34.2 pm 6.8 years and baseline metrics were high for fertility index. Post-surgery analysis showed 73.2% (n = 112) of the masses were benign, including mature cystic teratomas (44.4%, n = 68) and benign serous cystadenomas (28.8%, n = 44). Primary malignant neoplasms were confirmed in 26.8% (n = 41) of the specimens and the most common variant was high grade serous adenocarcinoma (17.0% of all specimens, n = 26). Three factors were strongly associated with malignant outcome: the advancing maternal age (35–45 years; p = 0.002), the presence of preoperative menstrual cycle irregularity (p < 0.001), and a positive family history of malignancy (p = 0.001) for these three factors. There were no statistical correlations found between parity (p = 0.507) and gravidity (p = 0.596) and tissue outcomes. Although the majority of adnexal surgeries performed in this age group of reproductive patients are benign, there is also a significant malignant burden of 26.8%. Thorough family lineage evaluation and clinical monitoring of menstrual track dysfunction and age should be used, with a higher priority given to this than the protective, albeit erroneous, assumption of high parity.