Natural history and malignant potential of simple ovarian cysts in postmenopausal women: a systematic review and meta-analysis

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doi:10.1097/GME.0000000000002163

Abstract

Importance

Postmenopausal ovarian masses are not uncommon, and the incidence of ovarian cancer rises sharply after menopause.

Objective

We conducted a systematic review and meta-analysis to investigate the natural history and malignant potential of postmenopausal simple ovarian cysts.

Evidence Review

PubMed, MEDLINE, EMBASE, CENTRAL (Cochrane Central Register of Controlled Trials), ClinicalTrials.gov, and ISRCTN (International Standard Randomized Controlled Trial Number Register) were searched from inception to January 31, 2022. Meta-analyses were conducted using R software.

Findings

Twelve cohort studies with 1,672 participants and 1,513 ovarian cysts were included. The rates of simple cysts remaining unchanged (38.90%; 95% CI, 19.79%-59.85%; P < 0.01) or disappearing (34.17%; 95% CI, 19.13%-50.93%; P < 0.01) were the highest during conservative observation. The surgery rate for the simple cyst was 19.04% (95% CI, 8.19%-32.92%; P < 0.01). The malignancy rate (including borderline tumors) was very low, approximately 1/10,000 (95% CI, 0% to 0.23%; P = 0.79).

Conclusions

Simple ovarian cysts in postmenopausal women were most likely to remain unchanged or disappear during follow-up. The malignancy rate was approximately 1 in 10,000. Personal preference is the most common reason for surgery.