Yang Chao, Wang Shan, Li Chang-Chun, Zhang Jun, Kong Xiang-Ru, Ouyang Jun
Department of Pediatric Surgical Oncology, Children's Hospital of Chongqing Medical University, Chongqing, China.
Eur J Gynaecol Oncol. 2011;32(3):289-92.
Ovarian germ cell tumors are rare in childhood. The goal of the study is to provide information that may help guide the evaluation and surgical management of future children with ovarian tumors.
A retrospective review of patients with ovarian germ cell tumors between January 1990 and January 2010 was performed.
137 patients were included with a median age of 9.5 years. Teratomas were found most frequently (mature: 78, immature: 6), followed by yolk sac tumors (n = 51), dysgerminoma (n = 1) and embryonal carcinoma (n = 1). Abdominal pain (81.8%) and abdominal distension (58.4%) were the most common symptoms. Twenty-six infants were found prenatally. Twenty-one patients presented torsion of the ovary. Alpha-feto-protein levels were elevated in all pure yolk sac tumors, two immature teratomas and one embryonal carcinoma. Most patients (84) were Stage I, 16 were Stage II, 23 Stage III, and four Stage IV. All patients with mature and immature teratomas (grade 1) underwent surgery alone. Surgery + chemotherapy were conducted in 55 other patients. The surgical procedures consisted of salpingo-oophorectomy (n = 68), oophorectomy (n = 21) and ovarian-sparing tumorectomy (n = 48). Sixteen patients gave up the treatment and died. Excluding this subset, 5-year relapse-free survival and overall survival was 93.4% and 98.3%, respectively. No recurrences were observed in any patients.
Ovarian germ cell tumors have an excellent prognosis. With accurate staging, complete resection, and adjuvant chemotherapy, patients should be expected to have excellent survival rates. Preservation of ovarian tissue should be considered whenever safe and feasible, however, this needs to be confirmed by studies on larger numbers of patients.
卵巢生殖细胞肿瘤在儿童期较为罕见。本研究的目的是提供有助于指导未来卵巢肿瘤患儿评估和手术治疗的信息。
对1990年1月至2010年1月期间患有卵巢生殖细胞肿瘤的患者进行回顾性研究。
共纳入137例患者，中位年龄为9.5岁。畸胎瘤最为常见（成熟型：78例，未成熟型：6例），其次是卵黄囊瘤（n = 51）、无性细胞瘤（n = 1）和胚胎癌（n = 1）。腹痛（81.8%）和腹胀（58.4%）是最常见的症状。26例患儿在产前被发现。21例患者出现卵巢扭转。所有纯卵黄囊瘤、2例未成熟畸胎瘤和1例胚胎癌患者的甲胎蛋白水平均升高。大多数患者（84例）为Ⅰ期，16例为Ⅱ期，23例为Ⅲ期，4例为Ⅳ期。所有成熟和未成熟畸胎瘤（1级）患者仅接受手术治疗。其他55例患者接受手术+化疗。手术方式包括输卵管卵巢切除术（n = 68）、卵巢切除术（n = 21）和保留卵巢的肿瘤切除术（n = 48）。16例患者放弃治疗并死亡。排除该亚组后，5年无复发生存率和总生存率分别为93.4%和98.3%。未观察到任何患者复发。
卵巢生殖细胞肿瘤预后良好。通过准确分期、完整切除和辅助化疗，患者有望获得优异的生存率。只要安全可行，应考虑保留卵巢组织，然而，这需要通过对更多患者的研究来证实。
