title: Treatment and ovarian preservation in children with ovarian tumors.
abstract: OBJECTIVE
  Ovarian preservation is desirable in children with ovarian tumors. However, the diagnostic and treatment strategies are heterogeneous. The aim of this study was to investigate the management and preservation of ovarian tissue in order to identify the factors associated with ovarian preservation.
  
  
  METHODS
  Thirty-seven patients (41 ovaries) were surgically treated for ovarian tumors. Four cases were bilateral. The data on the patient symptoms at presentation, imaging, treatment, outcome, pathology, and status of ovarian preservation were retrospectively analyzed for each patient.
  
  
  RESULTS
  Histological examinations revealed 25 mature teratomas, 5 immature teratomas, 5 cystadenomas, 2 dysgerminomas, and other tumors. Ovarian torsion occurred in 16 ovaries (39%). Ovary-sparing surgery was performed in 22 ovaries (53.7%). Successful ovarian preservation was significantly associated with a smaller tumor size, benign pathology, and a lower degree of torsion (P<0.01).
  
  
  CONCLUSIONS
  Because the prognosis was favorable in most cases, the preservation of fertility and gonadal function should be a goal in the surgical treatment of ovarian tumors. We recommend ovary-sparing surgery as the first-line treatment for all pediatric ovarian tumors other than those that are preoperatively diagnosed as being malignant and those in which emergent surgical intervention is indicated owing to the suspicion of ovarian torsion.
authors.affiliation: Department of Pediatric Surgery, Hyogo College of Medicine, Nishinomiya-shi, Hyogo, Japan. Electronic address: ta-oue@hyo-med.ac.jp.
authors.forename: Takaharu
authors.initials: T
authors.lastname: Oue
authors.affiliation: Department of Surgery, Division of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Uehara
authors.affiliation: Department of Pediatric Surgery, Hyogo College of Medicine, Nishinomiya-shi, Hyogo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sasaki
authors.affiliation: Department of Pediatric Surgery, Hyogo College of Medicine, Nishinomiya-shi, Hyogo, Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Nose
authors.affiliation: Department of Pediatric Surgery, Hyogo College of Medicine, Nishinomiya-shi, Hyogo, Japan.
authors.forename: Ryuta
authors.initials: R
authors.lastname: Saka
authors.affiliation: Department of Surgery, Division of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Yamanaka
authors.affiliation: Department of Surgery, Division of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: Takehisa
authors.initials: T
authors.lastname: Ueno
authors.affiliation: Department of Surgery, Division of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Tazuke
authors.affiliation: Department of Surgery, Division of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: Hiroomi
authors.initials: H
authors.lastname: Okuyama
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003537:Cystadenoma / Q000150:complications / Q000473:pathology / Q000601:surgery; D004407:Dysgerminoma / Q000150:complications / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D010049:Ovarian Diseases / Q000150:complications / Q000473:pathology; D010051:Ovarian Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D010052:Ovariectomy / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D013724:Teratoma / Q000150:complications / Q000473:pathology / Q000601:surgery; D014102:Torsion Abnormality / Q000150:complications / Q000473:pathology; D055815:Young Adult
keywords: Ovarian preservation; Ovarian tumor; Ovary-sparing surgery; Pediatric; Torsion