Transvaginal/Transabdominal Sonography for Histological Diagnosis in Advanced Ovarian Cancer Patients: A Single Institution Prospective Study
Aim: The primary aim was to evaluate the accuracy of transvaginal/transabdominal ultrasound-guided biopsy for histological diagnosis of primary advanced ovarian cancer. The secondary endopoints were feasibility, patientu2019s pain score during and after the procedure, complications and costs. Material and methods: We enrolled all consecutive women with clinically and radiologicallly suspicious advanced or metastatic ovarian cancer, who signed written informed consent. Patients who received NACT or with recurrent disease were excluded .Results:Between September 2018 and March 2019, 90 women were eligible for the study. Among them 8(9%) refused to participate. 44 patients were lost during enrollment. Of the remaining 38 patients, transvaginal/transabdominal ultrasound guided biopsy was not feasible in 12 (29%) due to technical difficulties. 26 successful procedures were performed. Site of biopsy was ovarian mass in 13 (50%) patients and pelvic peritoneum in the remaining 13 (50%). No major complications were recorded. One patient (3.8%) experienced temperature at 38u00b0C 24 hours after the procedure. Five patients (19.2%) experienced mild to moderate pelvic pain during the procedure (two patients had VAS score 4 and three had VAS score 3) which was controlled by oral analgesic therapy and lasted for a median time of 19 minutes (range, 10-35 minutes ). Accuracy rate of US guided biopsy compared to final histology was 88.4% (23/26 cases): 20 gynecological cancers and 3 non-gynecological cancers were diagnosed. In the remaining 3 cases histopathological diagnosis was not possible because of fibrosis in two cases and necrosis in one patient. Conclusions: transvaginal/transabdominal ultrasound-guided biopsy is a safe procedure, feasible in 70% of patients with suspicious primary advanced or metastatic ovarian cancer, with an accuracy rate at final histology of 88.4%.
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