Li Yan-fang, Li Men-da, Wu Qiu-liang, Liu Fu-yuan, Li Jun-dong, Zou Jing-lin, Huang Yong-wen
Department of Gynecologic Oncology, Zhongshan University, Guangzhou 510060, P. R. China.
Ai Zheng. 2002 Jan;21(1):79-82.
BACKGROUND & OBJECTIVE: Ovarian dysgerminoma is an uncommen ovarian malignancy. Its clinical features are special and there are many factors influencing the prognosis. If treated properly, the patient can be cured. Otherwise it may endanger the patient's life. The aim of this study is to investigate the clinical features and factors related to prognosis of ovarian dysgerminoma.
The data of 57 patients with pure Ovarian Dysgerminoma were analyzed retrospectively, who were admitted to Cancer Center, Sun Yat-sen University of Medical Sciences from January 1, 1964 to December 31, 2000.
The main clinical features were abdominal mass (56.1%), abdominal pain (21.1%), abdominal swelling(17.5%), vaginal bleeding(5.3%), genital tract abnormality (5.3%). Twenty-six patients had stage Idiseases, 8 stage II, 9 stage III, 1 stage IV and 13 recurrent and persistent diseases. The uterus was involved in 41.2% patients with stage II-III diseases. Combined modality was given to 52 cases and single-method treatment 5 cases. The overall 5-year and 10-year survival rate for stage I-IV was 80.1% and 70.0% respectively. The 5-year survival rate for stage I was 100%, stage II 55.2%, stage III 55.6%, stage IV 0% and recurrent and persistent diseases 72.7%. In the group of stage I, 12 patients received adnexectomy and 14 patients underwent hysterectomy and adnex removal, there was no significant difference between the 5-year and 10-year survival rate (all 100%) (P < 0.05). Of 23 patients in stage I group to whom only chemotherapy were given after operation, 19 cases received 3 or more courses and were well being without recurrence; four patients received only one course and one of them recurred 21 months after operation. In the group of stage II and III cases the 5-year survival rate was 86.7% for those whose chemotherapy courses were > or = 4 and 25.0% for patients who received less than 4 courses of chemotherapy (P < 0.05).
The prognosis of ovarian dysgerminoma is closely related to disease stage and modality of treatment. Fertility-preserving operation can be considered in early-staged patients, and be careful of doing so in middle-late staged cases. Good results can be achieved with operation-based combined modality in recurrent patients.
卵巢无性细胞瘤是一种罕见的卵巢恶性肿瘤。其临床特征特殊，影响预后的因素众多。若治疗得当，患者可治愈；否则可能危及生命。本研究旨在探讨卵巢无性细胞瘤的临床特征及与预后相关的因素。
回顾性分析1964年1月1日至2000年12月31日在中山医科大学肿瘤防治中心收治的57例纯卵巢无性细胞瘤患者的资料。
主要临床特征为腹部肿块（56.1%）、腹痛（21.1%）、腹胀（17.5%）、阴道流血（5.3%）、生殖道异常（5.3%）。26例为Ⅰ期疾病，8例为Ⅱ期，9例为Ⅲ期，1例为Ⅳ期，13例为复发及持续性疾病。Ⅱ - Ⅲ期疾病患者中41.2%累及子宫。52例采用综合治疗，5例采用单一方法治疗。Ⅰ - Ⅳ期患者总的5年和10年生存率分别为80.1%和70.0%。Ⅰ期患者5年生存率为100%，Ⅱ期为55.2%，Ⅲ期为55.6%，Ⅳ期为0%，复发及持续性疾病患者为72.7%。在Ⅰ期组中，12例患者行附件切除术，14例患者行子宫及附件切除术，5年和10年生存率无显著差异（均为100%）（P < 0.05）。Ⅰ期组中23例术后仅接受化疗的患者，19例接受3个或更多疗程化疗且情况良好无复发；4例仅接受1个疗程化疗，其中1例术后21个月复发。在Ⅱ期和Ⅲ期组中，化疗疗程≥4个的患者5年生存率为86.7%，接受化疗疗程少于4个的患者为25.0%（P < 0.05）。
卵巢无性细胞瘤的预后与疾病分期及治疗方式密切相关。早期患者可考虑保留生育功能手术，中晚期患者需谨慎。复发患者采用以手术为主的综合治疗可取得良好效果。
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