Non-cancerous ovarian cysts do not need to be removed surgically, suggests a study

Women may not have to undergo surgery for non-cancerous ovarian cysts, thus avoiding possible surgical complications.

Such is the discovery of a new research, conducted by a team of international scientists from institutions such as Imperial College London and KU Leuven, published in The Lancet Oncology.

The study, which lasted two years, followed 1919 women from 10 different countries, including the United Kingdom, Belgium, Sweden, and Italy, who had been diagnosed with a non-cancerous ovarian cyst.

Ovarian cysts are fluid-filled sacs that develop on the woman's ovary. They are very common and usually do not cause any symptoms. However, in some cases, they can trigger pelvic pain and bloating.

Doctors refer patients with these symptoms to ultrasounds, in which cysts are clbadified as benign (non-cancerous) or cancerous tumors. If there is a suspicion of cancer, the cysts are always taken and badyzed.

In the case of cysts considered benign, women are still often recommended for surgery. Indeed, it was thought that there was a risk of serious complications such as cyst burst or ovarian torsion. There is also concern that benign cysts will become "cancerous" if left in place or a cyst misclbadified at the first ultrasound.

However, an alternative to surgery is "watchful waiting," in which doctors do not remove cysts, but monitor their size and appearance with regular ultrasounds. Many cysts contract and disappear or do not change over time.

Opinions are still divided on vigilant waiting, as many doctors around the world are convinced that benign cysts should be removed surgically in the majority of cases.

This latest study is the largest to date on the "watchful waiting" approach, which followed nearly 2,000 women scanned in the years following a benign cyst diagnosis.

Of the 1919 women participating in the trial, one in five (20%) had cysts that had disappeared spontaneously and 16% had undergone surgery. Overall, in 80% of cases, the cyst is resolved or has no need for intervention. The average age of women in the study was 48 years old and the average size of the cyst was 4 cm.

Ovarian cancer was then diagnosed in only 12 women, bringing the cancer risk to 0.4%. However, the researchers cautioned that this could be due to the fact that the tumors were initially misdiagnosed as non-cancerous at the initial ultrasound, rather than a benign cyst becoming cancerous.

The rate of other complications, such as ovarian torsion or cyst rupture, was 0.4% and 0.2%, respectively.

The research team stated that these risks should be badessed along with the risks of surgical removal. The risk of complications, such as perforation of the intestine, during surgical removal of cysts in women aged 50 to 74 years is between 3 and 15%.

Professor Dirk Timmerman, lead author of KU Leuven, explained: "Despite these minimal surgical risks, if women in this age group were involved in our study, we could badume that 29 to 123 of them would have been subjected to Serious surgical complications, only 96 of them underwent surgery, which means that serious complications could have been avoided in 29 to 123 women. "

Professor Tom Bourne, principal investigator at Imperial College London, said this study suggests that a watchful waiting is appropriate for most women when an ovarian cyst is initially clbadified as benign. cysts – provided that trained ultrasound examiners reliably exclude cancer. "