Boran Nurettin, Tulunay Gökhan, Caliskan Eray, Köse M Faruk, Haberal Ali
SSK Ankara Maternity and Women's Health Teaching Hospital, Saglik sok. No: 18/3, 06410 Yenisehir, Ankara, Turkey.
Arch Gynecol Obstet. 2005 Feb;271(2):104-8. doi: 10.1007/s00404-004-0601-6. Epub 2004 Mar 9.
The medical records of 23 patients with pure ovarian dysgerminoma treated by conservative surgery at SSK Ankara Maternity Hospital between 1991 and 2001 were reviewed retrospectively. Pregnancy outcomes and menstrual function after conservative surgery were analyzed.
Seven patients (30%) were incompletely staged and were assumed to be stage IA due to intraoperative findings. Fifteen patients (70%) were surgically staged. As a result 15 patients (65.2%) were diagnosed to be stage I while 2 patients (8.6%) were staged II and 6 patients (26%) were staged III. Wedge biopsy of contralateral ovary was performed in 17 patients (74%) and tumor was diagnosed in 2 (11.7%). Adjuvant chemotherapy was applied in 16 (70%) of the cases. BEP (bleomycin, etoposide, and cisplatin) was the most frequently used regimen (39%). Recurrences were seen in 3 (13%) patients. The sites of recurrences were contralateral ovary in all cases. Recurrences were treated with surgery and radiotherapy. None of the patients died of disease. Nine patients were sexually active. Five of these patients had prior live births. Three of the primiparous patients delivered after treatment. Five pregnancies occurred in 3 nulliparous patients at the time of primary surgery. Three of these reached term and healthy babies were delivered. One pregnancy was terminated at 18 weeks of gestation due to anencephaly and a dilatation and curettage was performed at 6th week in another patient. Menstrual problems occurred in 4 (17.3%) of the 23 patients.
Fertility sparing treatments are safe in patients with pure ovarian dysgerminoma.
回顾性分析了1991年至2001年间在安卡拉SSK妇产医院接受保守性手术治疗的23例纯卵巢无性细胞瘤患者的病历。分析了保守性手术后的妊娠结局和月经功能。
7例患者（30%）分期不完全，根据术中发现假定为IA期。15例患者（70%）进行了手术分期。结果，15例患者（65.2%）被诊断为I期，2例患者（8.6%）为II期，6例患者（26%）为III期。17例患者（74%）对侧卵巢进行了楔形活检，其中2例（11.7%）诊断为肿瘤。16例（70%）患者接受了辅助化疗。BEP（博来霉素、依托泊苷和顺铂）是最常用的方案（39%）。3例（13%）患者出现复发。所有病例复发部位均为对侧卵巢。复发采用手术和放疗治疗。无一例患者死于疾病。9例患者有性生活。其中5例患者既往有活产史。3例初产妇在治疗后分娩。3例未产妇在初次手术时有5次妊娠。其中3例足月分娩，产下健康婴儿。1例妊娠因无脑儿在妊娠18周时终止，另1例患者在第6周进行了刮宫术。23例患者中有4例（17.3%）出现月经问题。
对于纯卵巢无性细胞瘤患者，保留生育功能的治疗是安全的。
