Follow up of women with simple ovarian cysts detected by transvaginal sonography in the Tokyo metropolitan area.
OBJECTIVE
To investigate the management of women with asymptomatic ovarian masses, to determine the appropriate duration of follow up, and to identify diagnostic indicators of growing cysts.


METHODS
Review of women's hospital records.


METHODS
Tokyo Metropolitan Cancer Detection Center, Japan.


METHODS
Two hundred and twenty-five pre- and postmenopausal women with a diagnosis of ovarian cyst < 6 cm in diameter and normal serum level of CA125, diagnosed between 1 October 1990 and 25 December 1991.


METHODS
Change in size of cyst as shown by ultrasound.


RESULTS
Seventy-five months after initial diagnosis, 29 (13%) of the masses had progressed, 31 (14%) had persisted, and 165 (73%) had regressed. One hundred and nine masses (48%) had regressed within six months of the initial diagnosis. In univariate analysis transvaginal ultrasonographic assessment of morphology findings, cyst diameter, carcinoembyronic antigen (CEA) and CA19-9 were associated with the prognosis of the cyst. Multivariate regression analysis demonstrated that only the initial serum CA19-9 level and serum CEA level were significant predictors of ovarian masses that regressed (P for trend = 0.004 and 0.02, respectively).


CONCLUSIONS
Simple ovarian cysts in patients with a normal level of CA125 have a low risk for ovarian cancer. Vaginal ultrasound at six months will identify regression of most simple cysts. CA19-9 and CEA at the initial diagnosis are useful parameters to predict future regression of ovarian cysts.
Sasaki
H
H
Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan.
Oda
M
M
Ohmura
M
M
Akiyama
M
M
Liu
C
C
Tsugane
S
S
Terashima
Y
Y
Tanaka
T
T
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D018394:CA-125 Antigen / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010048:Ovarian Cysts / Q000097:blood / Q000000981:diagnostic imaging* / Q000517:prevention & control / Q000601:surgery; D014041:Tokyo / Q000453:epidemiology; D014463:Ultrasonography
D018394:CA-125 Antigen; D002272:Carcinoembryonic Antigen