Pediatric ovarian malignancies: how efficacious are current staging practices?

Sarah C. Oltmann, Nilda M. Garcia, Robert Barber, Barry Hicks, Anne C. Fischer

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Purpose: Conventional staging is not routinely practiced because of a lack of preoperative indicators for pediatric ovarian malignancy. Children's Oncology Group (COG) developed guidelines for germ cell tumors to revise staging to correlate with primary pediatric ovarian pathology. Are COG guidelines being used, and are they applicable to all pediatric ovarian malignancies? Methods: A 151/2-year retrospective review of operative ovarian masses from a single academic center was performed. Results: There were 424 patients identified, with 46 malignancies (11%). Most were stage I (73%). Complete COG staging was performed in 24%. Each staging component performed was as follows: oophorectomy (91%), examination with or without biopsy of omentum (72%), peritoneum (67%), retroperitoneum (63%), contralateral ovary (56%), and washings (46%). Advanced stages had visible findings at exploration to guide biopsies. Of site-directed biopsies, 40.5% were positive, whereas all random biopsies (n = 38) were negative. Two recurrences and all mortalities (n = 4) had complete initial COG operative staging. Mean duration of follow-up was 3.62 ± 0.365 years. Conclusion: The COG staging is not consistently followed. All cases of advanced disease were visibly obvious and confirmed with site-directed biopsies. Random samplings were all negative and did not impact stage. Negative outcomes reflected inherent tumor biology not deviation from COG staging. The COG guidelines appear to be sufficient for all pediatric ovarian malignancies.

Original languageEnglish (US)
Pages (from-to)1096-1102
Number of pages7
JournalJournal of Pediatric Surgery
Issue number6
StatePublished - Jun 2010


  • Operative staging
  • Ovarian malignancy
  • Ovarian mass
  • Pediatric surgery

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health


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