Department of Pediatric Surgery, Childen's Hospital, 31059 Toulouse Cedex 9, France.
J Pediatr Surg. 2010 Jul;45(7):1484-90. doi: 10.1016/j.jpedsurg.2009.11.026.
BACKGROUND/PURPOSE: The aims of this study were to evaluate survival and ovarian prognosis in patients treated for ovarian germ cell tumor (OGCT) and to propose a decision-making protocol.
Charts of girls operated on for OGCT from 1976 up to 2009 were reviewed retrospectively. Tumor characteristics were assessed by tumor markers, imaging, and pathology.
Charts were available in 71 children presenting 75 OGCT. Tumors were benign in 58 cases and malignant in 17 cases. The average of the largest diameter of benign OGCT was significantly lower than that of malignant OGCT (76.5 +/- 49 mm versus 169 +/- 54 mm, P < .0001). Ovarian-sparing tumorectomy was carried out in 27 benign OGCT; 23 (85%) preserved ovaries were follicular. Malignant OGCTs were managed according to the protocols of the French Society for Pediatric Oncology. Bilateral oophorectomy had to be performed in 2 children. One patient presented a recurrence and 1 died.
In our series, both benign and malignant OGCTs have a good prognosis. A 75-mm cutoff size is proposed as an important criterion to preoperatively differentiate between benign and malignant tumors. In benign OGCT, ovarian-sparing tumorectomy leads to preserve ovaries in approximately 85% of cases, and in malignant OGCT, high survival rate has been obtained.
背景/目的：本研究旨在评估卵巢生殖细胞瘤（OGCT）患者的生存和卵巢预后，并提出决策方案。
回顾性分析了 1976 年至 2009 年间接受 OGCT 手术的女孩的病历。通过肿瘤标志物、影像学和病理学评估肿瘤特征。
共有 71 名儿童的病历可供查阅，其中 75 例为 OGCT。58 例肿瘤为良性，17 例为恶性。良性 OGCT 的最大直径平均值明显低于恶性 OGCT（76.5±49mm 与 169±54mm，P<.0001）。27 例良性 OGCT 行保留卵巢肿瘤切除术；23 例（85%）保留的卵巢为卵泡型。恶性 OGCT 根据法国儿科肿瘤学会的方案进行治疗。2 名儿童需要进行双侧卵巢切除术。1 例患者出现复发，1 例患者死亡。
在我们的研究中，良性和恶性 OGCT 均有良好的预后。提出 75mm 的截点大小作为术前区分良恶性肿瘤的重要标准。在良性 OGCT 中，保留卵巢肿瘤切除术可使约 85%的病例保留卵巢，而在恶性 OGCT 中，已获得较高的生存率。
