Findings on ovarian cyst resolution based on cyst diameter for the practicing physician (204)

Abstract

Objectives: The purpose of this study was to characterize the resolution of ovarian cysts for the practicing physician in terms of cyst diameter. Ovarian cysts frequently resolve on their own, but little information on this resolution based on cyst diameter is available for use by examining physicians. The objective of this study was to analyze the resolution of incident ovarian cysts in relation to cyst diameter, structure, age, body habitus, and menopausal status using univariate and multivariate analyses. These categorizations are important to examining physicians for decisions on whether to continue monitoring the cyst or intervene surgically. Methods: A total of 2,638 women with incident cysts who underwent 51,356 TVUS examinations were analyzed for over 31.2 years in the University of Kentucky Ovarian Cancer Screening Program. Prevalent cysts were excluded as they would be examined with an undefined course of the first appearance when defining resolution time. Other exclusions included women with concurrent ovarian malignancies, cysts with solid components and cases where surgery interrupted the natural history of measured cysts. Out of all the women in the study, 3,897 cysts were collectively identified and studied in a univariant and multivariant analysis through a clustering of variables identified in the patients. Results: Total 2,424 of the 3,897 cysts in the study were resolved; the remaining 1,473 cysts were treated as right-censored observations in the analysis. When considering multivariate analysis, septated cysts were 53.6% more likely to resolve than unilocular cysts (HR: 1.536, p<0.05). For every centimeter increase in diameter, the hazard for resolution decreased by 32.5% (HR: 0.675, p<0.05). The resolution was 34.2% less likely for women using HRT when compared to the nonusers (HR: 0.658, p<0.05). For every one-year increase in age, the hazard for resolution decreased by 2.1% (HR: 0.979, p<0.05). Univariate analysis revealed similar results for these four factors. With univariate analysis, post-menopausal women’s cysts were 21.2% less likely to resolve than pre-menopausal women’s cysts; however, this finding was not significant in multivariate analysis. Objectives: The purpose of this study was to characterize the resolution of ovarian cysts for the practicing physician in terms of cyst diameter. Ovarian cysts frequently resolve on their own, but little information on this resolution based on cyst diameter is available for use by examining physicians. The objective of this study was to analyze the resolution of incident ovarian cysts in relation to cyst diameter, structure, age, body habitus, and menopausal status using univariate and multivariate analyses. These categorizations are important to examining physicians for decisions on whether to continue monitoring the cyst or intervene surgically. Methods: A total of 2,638 women with incident cysts who underwent 51,356 TVUS examinations were analyzed for over 31.2 years in the University of Kentucky Ovarian Cancer Screening Program. Prevalent cysts were excluded as they would be examined with an undefined course of the first appearance when defining resolution time. Other exclusions included women with concurrent ovarian malignancies, cysts with solid components and cases where surgery interrupted the natural history of measured cysts. Out of all the women in the study, 3,897 cysts were collectively identified and studied in a univariant and multivariant analysis through a clustering of variables identified in the patients. Results: Total 2,424 of the 3,897 cysts in the study were resolved; the remaining 1,473 cysts were treated as right-censored observations in the analysis. When considering multivariate analysis, septated cysts were 53.6% more likely to resolve than unilocular cysts (HR: 1.536, p<0.05). For every centimeter increase in diameter, the hazard for resolution decreased by 32.5% (HR: 0.675, p<0.05). The resolution was 34.2% less likely for women using HRT when compared to the nonusers (HR: 0.658, p<0.05). For every one-year increase in age, the hazard for resolution decreased by 2.1% (HR: 0.979, p<0.05). Univariate analysis revealed similar results for these four factors. With univariate analysis, post-menopausal women’s cysts were 21.2% less likely to resolve than pre-menopausal women’s cysts; however, this finding was not significant in multivariate analysis.