Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Petrova 13, 10000, Zagreb, Croatia.
Children's Hospital Zagreb, Zagreb, Croatia.
Arch Gynecol Obstet. 2020 May;301(5):1227-1233. doi: 10.1007/s00404-020-05522-5. Epub 2020 Apr 6.
To describe a case series of patients with malignant ovarian germ cell tumors (MOGCT) treated exclusively with fertility-sparing surgery (FSS) with or without adjuvant chemotherapy.
We retrospectively reviewed the records of 27 patients with MOGCT treated in the Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Croatia, between January 2009 and July 2019.
The median age at diagnosis was 22 years, and the main symptom was abdominal distension (57.0%). The most prevalent histological subtype was immature teratoma (n = 13, 48.1%). Twenty-three patients (85.2%) had laparotomy and 4 (14.8%) had laparoscopy, without conversions. Lymphadenectomy was performed in 16 (59.3%) patients, with 184 removed lymph nodes, and omentectomy was performed in 19 (70.4%) patients. The rate of chemotherapy administration was 81.5%. The follow-up length ranged between 6.30 and 115.1 months (median: 49.60 months). No patient experienced tumor recurrence. The rate of complete gross resection was 100%. At the time of analysis, all patients were alive and disease free. Fifty percent of patients who actively tried to conceive after FSS became pregnant, with 12 deliveries.
This study suggests that FSS is a safe treatment option for MOGCT, regardless of tumor stage and histological type.
描述一组接受单纯保留生育功能手术（FSS）联合或不联合辅助化疗治疗的恶性卵巢生殖细胞肿瘤（MOGCT）患者的病例系列。
我们回顾性分析了 2009 年 1 月至 2019 年 7 月期间在克罗地亚萨格勒布大学医院妇产科接受治疗的 27 例 MOGCT 患者的病历。
诊断时的中位年龄为 22 岁，主要症状为腹胀（57.0%）。最常见的组织学亚型为未成熟畸胎瘤（n=13，48.1%）。23 例（85.2%）患者接受了剖腹手术，4 例（14.8%）接受了腹腔镜手术，无中转开腹。16 例（59.3%）患者进行了淋巴结切除术，切除淋巴结 184 枚，19 例（70.4%）患者进行了大网膜切除术。化疗使用率为 81.5%。随访时间为 6.30 至 115.1 个月（中位数：49.60 个月）。无患者出现肿瘤复发。完全肉眼切除率为 100%。在分析时，所有患者均存活且无疾病。50%的 FSS 后积极尝试妊娠的患者成功怀孕，分娩 12 例。
本研究表明，无论肿瘤分期和组织学类型如何，FSS 都是 MOGCT 的一种安全治疗选择。
