Perimenopausal management of ovarian endometriosis and related cancer risk : When is medical or surgical treatment indicated?
Articolo
Data di Pubblicazione:
2018
Citazione:
Perimenopausal management of ovarian endometriosis and related cancer risk : When is medical or surgical treatment indicated? / P. Vercellini, P. Viganò, L. Buggio, S. Makieva, G. Scarfone, F.M. Cribiù, F. Parazzini, E. Somigliana. - In: BAILLIERE'S BEST PRACTICE & RESEARCH. CLINICAL OBSTETRICS & GYNAECOLOGY. - ISSN 1521-6934. - 51:(2018 Aug), pp. 151-168. [10.1016/j.bpobgyn.2018.01.017]
Abstract:
In women with endometriosis the lifetime risk of ovarian cancer is increased from 1.4% to about 1.9%. The risk of clear cell and endometrioid ovarian cancer is, respectively, tripled and doubled. Atypical endometriosis, observed in 1-3% of endometriomas excised in premenopausal women, is the intermediate precursor lesion linking typical endometriosis and clear cell/endometrioid tumors. Prolonged oral contraceptive use is associated with a major reduction in ovarian cancer risk among women with endometriosis. Surveillance ± progestogen treatment or surgery should be discussed in perimenopausal women with small, typical endometriomas. In most perimenopausal women with a history of endometriosis but without endometriomas, surveillance instead of risk-reducing bilateral salpingo-oophorectomy seems advisable. Risk-reducing salpingo-oophorectomy might benefit patients at particularly increased risk, but the evidence is inconclusive. Risk profiling models and decision aids may assist patients in their choice. Screening of the general perimenopausal population to detect asymptomatic endometriomas is unlikely to reduce disease-specific mortality.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
endometriosis; ovarian cancer; risk-reducing salpingo-oophorectomy; endometrioma; medical treatment; screening; early diagnosis
Elenco autori:
P. Vercellini, P. Viganò, L. Buggio, S. Makieva, G. Scarfone, F.M. Cribiù, F. Parazzini, E. Somigliana
Link alla scheda completa: