Different features of the histopathological subtypes of ovarian tumors in pre- and postmenopausal women

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Abstract

Objective:

To date, epidemiological evidence has consistently supported a link between ovarian cancer risk and menopause. However, little is known about how menopause status affects the risk of specific histological subtypes of ovarian tumors. We aimed to analyze the differences in various histopathological subtypes of ovarian tumors between pre- and postmenopausal women.

Methods:

We reviewed the medical records of women who underwent surgery for ovarian tumors and received histopathological confirmation at the Busan Paik Hospital between January 1997 and October 2016. Pathological findings were regrouped according to 2014 World Health Organization (WHO) classification and subdivided into the following five main categories: epithelial, germ cell, sex cord-stromal, tumor-like lesions, and secondary tumors.

Results:

A total of 4,683 cases (3,404 premenopausal and 1,279 postmenopausal) were included in this study. Among the 4,683 neoplasms, epithelial tumors accounted for 52.6%, germ cell tumors for 27.1%, sex cord-stromal tumors (SCSTs) for 4.1%, tumor-like lesions for 14.0%, and secondary tumors for 0.8%. Among the epithelial tumors, malignant epithelial tumors were significantly associated with postmenopausal women (5.4% vs 22.1%, P < 0.0001), whereas benign epithelial tumors were significantly associated with premenopausal women (40.5% vs 31.9%, P < 0.0001). Among the 1,271 cases of germ cell tumors, most (97.6%) were benign mature teratoma and 2.4% were malignant germ cell tumors. Germ cell tumors were noted more frequently in premenopausal women than in postmenopausal women (31.3% vs 16.1%, P < 0.0001). Among the 194 cases of SCSTs, fibrothecoma was the most common (71.6%) followed by adult granulosa cell tumor (12.9%). The majority of SCSTs occurred in postmenopausal women (2.1% vs 9.5%, P < 0.0001). Among the 656 cases of tumor-like ovarian lesions, corpus luteum cyst was the most common (31.9%) followed by tubo-ovarian abscess (27.6%). Tumor-like ovarian lesions were significantly associated with premenopausal women (15.2% vs 10.7%, P = 0.0001). Among the 36 cases of secondary tumors, 66.7% of the metastatic ovarian tumors were Krukenberg tumors. There was no significant difference in the incidence of secondary tumors between the groups.

Conclusions:

We demonstrated the differences in diverse histological subtypes of ovarian tumors according to the menopause status based on the new WHO classification for Korean women.

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