Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, People's Republic of China.
Arch Gynecol Obstet. 2020 Apr;301(4):901-912. doi: 10.1007/s00404-020-05502-9. Epub 2020 Mar 17.
Non-gestational ovarian choriocarcinoma (NGOC) is a rare malignant germ cell tumor. Through literature review and cases collection, we aim to analyze prognostic factors for NGOC and summarize its clinicopathological characteristics to guide the individualized treatment.
We searched PubMed database, Cochrane library, and Google Scholar for cases published between January 1, 1967 and July 31, 2018 using various search terms. We retrieved patients' clinicopathological characteristics, treatment, and prognosis information from included studies. These patients were divided into two groups: died (case group) or alive (control group) group. We summarized and compared their clinical (age, symptoms, R0 resection, serum HCG levels, chemotherapy regimen) and pathological (pure vs non-pure type, tumor size, tumor location, metastasis sites, stage) features by statistical analysis.
Only 39 patients were retrieved from 36 studies in total. The median age was 30 years (range 12- to 65-years old). The peak incidence was in the adolescent age 12-25 years. Median follow-up was 20.3 months (range 1-84 months). 9 (23%) patients died; 24 (62%) patients were alive; 6 (15%) were lost to follow-up. Upon univariate analysis, we found age had a poor impact on overall survival (OS) in NGOC, HR - 0.057, 95% CI - 0.111 to - 0.004. Pure type NGOC has a better OS than mixed type, HR - 2.621, 95% CI - 4.577 to - 0.666. R0 resection is a good prognostic factor for OS, HR 2.967, 95% CI 0.709-5.224.
Clinicians should try to achieve R0 resection to improve the prognosis for NGOC patients even among advanced patients.
非妊娠性卵巢绒毛膜癌（NGOC）是一种罕见的恶性生殖细胞肿瘤。通过文献回顾和病例收集，我们旨在分析 NGOC 的预后因素，并总结其临床病理特征，以指导个体化治疗。
我们在 PubMed 数据库、Cochrane 图书馆和 Google Scholar 上使用各种检索词检索了 1967 年 1 月 1 日至 2018 年 7 月 31 日期间发表的病例。我们从纳入的研究中检索了患者的临床病理特征、治疗和预后信息。这些患者被分为两组：死亡（病例组）或存活（对照组）组。我们通过统计分析总结并比较了他们的临床（年龄、症状、R0 切除、血清 HCG 水平、化疗方案）和病理（纯型与非纯型、肿瘤大小、肿瘤位置、转移部位、分期）特征。
总共从 36 项研究中检索到 39 例患者。中位年龄为 30 岁（范围 12-65 岁）。发病高峰在青少年 12-25 岁。中位随访时间为 20.3 个月（范围 1-84 个月）。9 例（23%）患者死亡；24 例（62%）患者存活；6 例（15%）失访。单因素分析发现，年龄对 NGOC 的总生存（OS）有不良影响，HR-0.057，95%CI-0.111 至-0.004。纯型 NGOC 的 OS 优于混合型，HR-2.621，95%CI-4.577 至-0.666。R0 切除是 OS 的良好预后因素，HR 为 2.967，95%CI 为 0.709-5.224。
即使在晚期患者中，临床医生也应努力实现 R0 切除，以改善 NGOC 患者的预后。
